In hospital mortality of chronic obstructive pulmonary disease after Intensive Care Unit discharge
Keywords:
chronic obstructive pulmonary disease, mortality, intensive care unitsAbstract
Introduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant cause of in-hospital morbidity and mortality. The in-hospital mortality rate of patients who, after requiring mechanical ventilation (MV) in the intensive care unit (ICU), are discharged to a general ward remains unknown.
Objective: To determine in-hospital mortality in patients discharged from the ICU who required MV for at least 24 hours.
Methods: A case series study was conducted on AECOPD episodes requiring MV for at least 24 hours. The analyzed variables included age, sex, skin color, cause of AECOPD, Acute Physiology and Chronic Health Evaluation (APACHE II) score, airway management, MV duration, pre-ICU stay, ICU stay, readmission, post-ICU stay, and discharge outcome. A descriptive analysis of the variables was performed. The chi-square test of independence was used, followed by binary logistic regression analysis, and finally, classification effectiveness was evaluated using a receiver operating characteristic (ROC) curve.
Results: The study included 49 patients discharged from the ICU to a conventional ward. 15 patients died (30.6%), while 34 survived (69.4%). It was found that an APACHE-II score > 15 upon ICU admission (p< 0.001) and having Black skin (p= 0.007) were associated with worse in-hospital outcomes.
Conclusions: Patients with AECOPD demonstrated higher in-hospital mortality following ICU discharge compared to mortality during intensive care. The study identified key predictors of post-ICU mortality.
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