Predictive risk factors for Intensive Care Unit mortality in Acute Exacerbations of COPD requiring Invasive Mechanical Ventilation

INTRODUCTION: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently necessitate intensive care unit (ICU) admissions. The purpose of this study is to determine risk factors for ICU mortality in AECOPD who required invasive mechanical ventilation (IMV).
METHODS: Patients requiring IMV for AECOPD between January 2013 and March 2019 were retrospectively reviewed. Patients’ characteristics, comorbidities, and laboratory results were reviewed from the medical charts. Subjects’ acute physiology and chronic health evaluation (APACHE) II score, Glasgow Coma Scale (GCS), IMV (days), and mortality were recorded. As an output or dependent variable, ICU mortality was considered. Other variables were considered to independent factors or risk factors. Then, Logistic regression analysis was performed to determine risk factors for ICU mortality in AECOPD.
RESULTS: The study, 134 patients were included. The mean duration of IMV were 11.6 ± 12.2 days. The ICU mortality were 51.4 %. On admission to ICU, patients had APACHE-II scores of 23.0 ± 6.2. Nonsurvivors had lower blood Mg levels (1.8 ± 0.2 mmol/L, p = 0.002), lower blood Ca levels (8.0 ± 0.7 mg/dL, p = 0.005), higher Uric Acid, (8.5±3.8 mg/dl, p = 004), higher CRP levels (87.2 ± 71.8 mg/dl, p = 0.048), higher leukocyte count (14.7 ± 10.2 103L, p= 0.040), higher serum lactate (2.3 ± 1.7 mmol, p = 0.003) compared to survivors.
DISCUSSION AND CONCLUSION: APACHI score and uric acid level were found statististically significant risk factors for ICU mortality.