Factors affecting mortality and patient outcome in patients with COPD followed in the intensive care unit

Abstract

Objective: COPD is characterized by exacerbation and may lead to intensive care unit admission in cases such as pneumonia and sepsis. While non-invasive mechanical ventilation is the first treatment option in intensive care units, it reduces mortality and hospitalization. In our study, we aimed to determine the factors affecting mortality in patients with COPD admitted to intensive care unit. Materials and Methods: In our study, the data of patients admitted to the intensive care unit of Bolu Izzet Baysal State Hospital with COPD were evaluated retrospectively. Duration of intensive care unit stay, APACHE II score, comorbidities, need for noninvasive mechanical ventilation, CRP albumin ratio and leukocyte lymphocyte ratio were recorded. Results: A total of 416 patients, including 177 (42.5%) women, were included in our study. Of the patients, 107 (25.7%) (Group 1) were admitted to ICU for COPD exacerbation, 183 (44%) (Group 2) for pneumonia and 126 (30.3%) (Group 3) for sepsis. Hypertension was the most common comorbidity in 112 patients (26.9%). Mortality was higher in patients with pneumonia and sepsis than in patients with COPD exacerbation. When all patients were compared according to prognosis, age, length of ICU stay, NLR, CAR and APACHE II scores were higher in patients who died. The duration of non-invasive mechanical ventilation was higher in patients with an episode of COPD, while mortality was higher in patients receiving invasive mechanical ventilation support. CONCLUSION While pneumonia and sepsis increase mortality in patients with COPD, NIMV has a favorable prognosis in these patients with encouraging results.