Comorbidities and short-term prognosis in patients admitted to the intensive care unit for acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective To investigate the correlation between the comorbidities and the mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to intensive care unit (ICU). Methods A retrospective cohort study was conducted for AECOPD patients admitted to the Medical Intensive Care Unit/Respiratory Intensive Care Unit (MICU/RICU) of Peking University Third Hospital from January 1, 2011 to December 31, 2017.The clinical data on admission, numbers and scores of comorbidities, and the clinical outcomes during hospitalization were recorded.The association of comorbidities with hospital mortality of AECOPD patients was analyzed using multivariate Logistic regression method. Results A total of 158 AECOPD patients who met the inclusion criteria were enrolled in the study cohort, with an hospital mortality of 14.56% (23/158). Univariate analysis showed that age, age-adjusted Charlson comorbidities index (ACCI)≥7, arrhythmia, heart failure, the number of combined cardiovascular diseases (N)≥1 and N≥3 were significantly different between the death group and the survival group (P<0.05). Multivariate Logistic regression model analysis showed that arrhythmia and ACCI≥7 were independent predictors of hospital mortality.Patients with arrhythmias had a 3.709-fold risk of death during hospitalization (OR=3.709, 95%CI: 1.383-9.945, P<0.001), and patients with ACCI≥7 had a 4.292-fold risk of death during hospitalization (OR=4.292, 95%CI: 1.589-11.596, P=0.004). Conclusions The hospital mortality of severe AECOPD patients was 14.56% in our cohort.Cardiac arrhythmia and ACCI≥7 were independent risk factors associated with hospital death of AECOPD patients. Key words: Pulmonary disease, chronic obstructive, acute exacerbation; Hospital mortality; Comorbidities