Predictors of In-hospital Outcomes in Hospitalized Patients With COPD Exacerbation

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant mortality. Objectives: The present study aimed to identify the risk factors that contribute to hospital outcomes of patients admitted with COPD exacerbation. Methods: This prospective cross-sectional study was performed on 74 patients hospitalized with COPD exacerbation. Pulse oximetry, complete blood count, high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and venous blood gas were taken under standard conditions. The clinical condition of patients was scored based on the COPD Assessment Test (CAT) and shortness of breath based on the standard, modified Medical Research Council (mMRC) questionnaire. The patients were divided into three groups based on in-hospital outcomes (i.e., favorable, unfavorable, and terrible or worse). One-way analysis of variance, chi-square test, logistic regression model, and odds ratio (OR) analysis were used to determine the most important factors associated with outcomes. A P-value less than 0.05 was considered statistically significant. Results: Out of 74 patients, 43 (58.1%) and 31 (41.9%) subjects were male and female, respectively. The patients’ mean age was 68.19 ± 10.62 years. The number (%) of patients in favorable, unfavorable, and worse outcome groups was 27 (36.48%), 30 (40.54%), and 17 (22.97%), respectively. As the CAT and mMRC score increased, the chance of terrible outcomes also increased (OR = 1.22, confidence interval (CI): 1.10 - 1.35). There was no significant correlation between worse outcomes and hs-CRP. The PCT was significantly higher in the group with worse outcomes than in the groups with favorable and unfavorable outcomes (P < 0.01). Conclusions: The COPD evaluation by the CAT and mMRC plays an important role in the in-hospital outcomes of hospitalized COPD patients with exacerbation. The serum level of PCT was also a determinant factor of prognosis in hospitalized patients with COPD exacerbation.