Open AccessLong‐term outcome of chronic obstructive pulmonary disease patients with acute respiratory failure following intensive care unit discharge in T urkey
Author(s) -
Ocal Serpil,
Ortac Ersoy Ebru,
Ozturk Ozge,
Hayran Mutlu,
Topeli Arzu,
Coplu Lutfi
Publication year - 2017
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12450
Subject(s) - medicine , copd , intensive care unit , mechanical ventilation , mortality rate , tertiary referral hospital , pulmonary disease , respiratory failure , intubation , referral , emergency medicine , intensive care medicine , retrospective cohort study , surgery , family medicine
Objectives Chronic obstructive pulmonary disease (COPD) remains a globally significant cause of mortality, although COPD mortality varies from country to country, and across different regions within each country. The primary objective of this study was to determine the mortality rates of COPD patients who present with acute respiratory failure (ARF) to a tertiary care referral center in different stages of their follow‐up (ICU, in‐hospital and after discharge). The secondary objective was to determine factors associated with mortality in this group of patients. Results Medical records of consecutive COPD patients over a 10‐year period were reviewed.The study included 147 patients. Of these, 72 were treated initially with noninvasive positive pressure ventilation (NIPPV), and 12 of these required intubation after NIPPV failed. Therefore, 86 patients were intubated for invasive mechanical ventilation (IMV), while NIPPV was succesful in 60 patients. Survival time was independently associated with advanced age, high APACHE II score, co‐morbidity and the need for IMV. The cumulative mortality was 27% in the medical ICU and 31% in hospital following ICU discharge. The mortality rate at 1, 2 and 5 years was 54%, 66% and 84%, respectively. Conclusion COPD patients admitted to the ICU for ARF have an approximately 70% chance of leaving hospital alive, but half of these may die in the first 6 months after discharge. The risk factors related to mortality were advanced age, high APACHE II score, co‐morbidity and IMV requirement.