Outcomes of COPD Patients in RICU Ain Shams University Hospital and ICU Mansura

Abstract

Abstract Background Chronic obstructive pulmonary disease (COPD) is a disease characterized by progressive, persistent, expiratory airflow limitation that is not fully reversible. In the United States, COPD annually accounts for $29.5 billion in direct health care costs, 750,000 hospitalizations, and 1.5 million emergency visits. Globally it is now ranked as the fifth leading cause of death. An exacerbation of COPD is characterized by an acute worsening of a patient's respiratory symptoms that result in change in treatment and increased utilization of health care resources. Objective the aim of this work was to evaluate the characteristics and clinical outcomes of COPD patients admitted to RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital. Patients and Methods This was an observational study conducted on a total of 100 patients admitted to ICU with acute exacerbation of Chronic Obstructive Pulmonary Disease at RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital within the period from November 2019 to April 2020. We excluded patients with obstructive lung disease other than COPD, Restrective lung disease, Malignancy and TB. The all cases were subjected to Full detailed medical history and full thorough clinical examination. We assessed the outcomes in regard to Length of stay (LOS) and MV duration. Assessment of the outcome which was be either death or discharge to chest ward, home or referral to any other department to complete the treatment. Results The study demonstrated that, the prevalence was 78% survival versus 22% mortality. there was a statistically significant difference among survivors and dead in terms of the cause of admission, there was statistically significant increase among dead cases compared to the survivors regarding APACHE II score, there was there was highly statistically significant decrease in terms of all PH measurements and all PCO2 measurements but there were no statistically significant differences among dead cases and survivors regarding all PO2 measurements, all HCO3 measurements and all SaO2 measurements. Conclusion Mortality was demonstrated to be correlated with several factors such as presence of co-morbidity, original cause of admission, APACHE II score, ABG parameters, WBCs, neutrophils, creatinine, urea, Reintubation, and complications of invasive ventilation.