Abstract
Background and Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a common, costly and preventable disease and is at present the fourth leading cause of death globally. To study the outcome of patients with acute exacerbation of COPD and to analyse the risk factors predicting adverse outcomes in patients with acute exacerbation of COPD.
Patients and Methods: A Prospective study was conducted over a period of one year, from December 2021 to December 2022, Minimum of 50 patients, both male and female with AECOPD getting admitted to a Tertiary care centre were included in this study.
Results: Of the 50 patients studied, 42 were males; all of them were smokers (84%). The mean age was 64.34 ± 10.47 years. The mean duration of the disease was 10.04±6 years. All patients presented with cough, recent worsening of Dyspnea and increased sputum purulence/volume. 70% patients had one or more associated co-morbid illness, majority had hypertension (40%). Of 32 patients with Respiratory failure on admission 17(53.12%) patients had Type II and 15(46.28%) had Type I failure. 44 patients received medical management and 6 patients required invasive mechanical ventilation (IMV). Overall mortality was 5 (10%). 20 variables were compared between survivors and non-survivors. Univariate sensitivity analysis revealed that presence of altered sensorium (P=0.001), Hypotension (P=0.02), cyanosis (P=0.00463), pedal edema (P=0.02), presence of infection (P=0.024) Severe Acidosis (P=0.012), Hypercapnia (P=0.016), cor pulmonale (P=0.04), at the time of admission and need for invasive mechanical ventilation (P<0.001) as predictors of mortality.
Conclusions: 64% of AECOPD presented with respiratory failure, majority were type II. Overall mortality was 10%. Altered Sensorium, pedal edema, presence of infection, cyanosis, hypotension, severe acidosis, hypercapnia and presence of cor pulmonale at the time of admission predict adverse outcome. Those who need invasive mechanical ventilation had high mortality. Survivors had less hospital stay.