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Original Article
- Pulmonary
- Characteristics and outcomes of patients with chronic obstructive pulmonary disease admitted to the intensive care unit due to acute hypercapnic respiratory failure
- Türkay Akbaş, Harun Güneş
- Acute Crit Care. 2023;38(1):49-56. Published online February 27, 2023
- DOI: https://doi.org/10.4266/acc.2022.01011
- 4,664 View
- 267 Download
- 8 Web of Science
- 6 Crossref
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Abstract
PDF - Background
The study aimed to describe the clinical course, outcomes, and prognostic factors of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure.
Methods
This retrospective study involved patients with acute hypercapnic respiratory failure due to COPD of any cause admitted to the intensive care unit (ICU) for non-invasive or invasive mechanical ventilation (IMV) support between December 2015 and February 2020.
Results
One hundred patients were evaluated. The main causes of acute hypercapnic respiratory failure were bronchitis, pneumonia, and heart failure. The patients’ mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 23.0±7.2, and their IMV rate was 43%. ICU, in-hospital, and 90-day mortality rates were 21%, 29%, and 39%, respectively. Non-survivors had more pneumonia, shock within the first 24 hours of admission, IMV, vasopressor use, and renal replacement therapy, along with higher APACHE II scores, lower admission albumin levels and PaO2/ FiO2 ratios, and longer ICU and hospital stays than survivors. Logistic regression analysis identified APACHE II score (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.017–1.317; P=0.026), admission PaO2/FiO2 ratio (OR, 0.989; 95% CI, 0.978–0.999; P=0.046), and vasopressor use (OR, 8.827; 95% CI, 1.650–47.215; P=0.011) as predictors of ICU mortality. APACHE II score (OR, 1.099; 95% CI, 1.021–1.182; P=0.011) and admission albumin level (OR, 0.169; 95% CI, 0.056–0.514; P=0.002) emerged as predictors of 90-day mortality.
Conclusions
APACHE II scores, the PaO2/FiO2 ratio, vasopressor use, and albumin levels are significant short-term mortality predictors in severely ill COPD patients with acute hypercapnic respiratory failure. -
Citations
Citations to this article as recorded by
- Breaking new ground: machine learning enhances survival forecasts in hypercapnic respiratory failure
Zhongxiang Liu, Bingqing Zuo, Jianyang Lin, Zhixiao Sun, Hang Hu, Yuan Yin, Shuanying Yang
Frontiers in Medicine.2025;[Epub] CrossRef - Antibiotics in COPD exacerbations requiring mechanical ventilation: a dogma to be re-evaluated
Sebastian Osorio-Rico, Daniel Perez-Marin, John Cardeño-Sanchez
Internal and Emergency Medicine.2024; 19(5): 1505. CrossRef - Opportunities and perspectives of small molecular phosphodiesterase inhibitors in neurodegenerative diseases
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European Journal of Medicinal Chemistry.2024; 271: 116386. CrossRef - Development and Validation of an In-Hospital Mortality Prediction Model for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Wenjie Sun, Yeshan Li, Shuxin Tan
International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1303. CrossRef - Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients
Liuhua Pan
American Journal of Translational Research.2024; 16(12): 7830. CrossRef - COPD Exacerbation: Why It Is Important to Avoid ICU Admission
Irene Prediletto, Gilda Giancotti, Stefano Nava
Journal of Clinical Medicine.2023; 12(10): 3369. CrossRef
- Breaking new ground: machine learning enhances survival forecasts in hypercapnic respiratory failure
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