AimTo determine in-hospital and post-discharge mortality, readmission rates, and predictors of invasive mechanical ventilation (IMV) in patients treated at intensive care unit (ICU) due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD).MethodsA retrospective observational cohort study included all patients treated at a respiratory ICU for AECOPD during one year. A total of 62 patients (41 men) with mean age 68.4 ± 10.4 years were analyzed for outcomes including in-hospital and post-discharge mortality, readmission rates, and IMV. Patients’ demographic, hematologic, biochemical data and arterial blood gas (ABG) values were recorded on admission to hospital. Mean duration of follow-up time was 2.4 years.ResultsOf 62 patients, 7 (11.3%) died during incident hospitalization and 21 (33.9%) died during the follow-up. The overall 2.4-year mortality was 45.2%. Twenty nine (46.8%) patients were readmitted due to AECOPD. The average number of readmissions was 1.2. Multivariate analysis showed that blood pH, bicarbonate levels, low albumin, low serum chloride, and low hemoglobin were significant predictors of IMV during incident hospitalization (P < 0.001 for the overall model fit).ConclusionHigh in-hospital and post-discharge mortality and high readmission rates in our patients treated due to AECOPD at ICU indicate that these patients represent a high risk group in need of close monitoring. Our results suggested that anemia, hypoalbuminemia, and elevated troponin levels were risk factors for the need of IMV in severe AECOPD. Identification of such high-risk patients could provide the opportunity for administration of an appropriate and timely treatment.

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Background: It is well known that acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with increased morbidity, readmission rates and mortality, but few studies report rehospitalization and mortality rate after severe AECOPD treated in intensive care unit (ICU). The aim of our study was to assess two year readmission rates and mortality in AECOPD patients treated in ICU and to identify determinants of these outcomes. Methods: 55 patients (35 men) mean age 68.1 (±10.5) years successfully treated in respiratory ICU due to AECOPD and discharged from hospital were included in the study. Patients demographics, hematology, biochemistry and arterial blood gases on the first treating day were recorded. Results: During the median follow-up of 2.4 years, 29 (46.8%) patients had one or more readmissions due to AECOPD. The average number of readmissions was 1.2. Significant predictors for the time to next hospitalization were initial PaCO2, fibrinogen, proteins and alpha 2 globulins (p=0.001 for the overall model fit). Significant predictors for the number of readmissions were: age at admission, neutrophil count, serum sodium, bilirubin, coronary artery disease (p<0.001 for the overall model fit). During the follow-up, 21 (38.2%) patients died. Significant predictors for survival time after incident hospitalization were: BMI, monocyte count, serum LDH, cancer and hypertension (p<0.001 for the overall model fit). Conclusion: Our study suggests that patient age, comorbidity, BMI and certain biochemistry parameters are potential predictors of readmission and poor outcome after AECOPD treated in ICU. Further studies are needed to verify our findings.