RT Journal Article
SR Electronic
T1 Prevalence and prognosis of critically ill patients with COPD between 1998 and 2008
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2049
VO 38
IS Suppl 55
A1 Georg-Christian Funk
A1 Peter Bauer
A1 Otto Chris Burghuber
A1 Andreas Fazekas
A1 Sylvia Hartl
A1 Barbara Metnitz
A1 Philip Metnitz
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2049.abstract
AB Background: Little is known about the prevalance and outcome of patients with COPD treated in ICUs. Such information is valuable for the planning of resources e.g. respiratory care units and weaning facilities.Aims and objectives: We speculated that COPD would be an increasing problem in critically ill patients and would be associated with increased morbidity and mortality.Methods: We analysed prospectively collected data of 194,453 adults treated in 87 Austrian ICUs over a period of 11 years (1998-2008).Results: COPD was present in 9% of all ICU patients. The risk-adjusted mortality of patients with COPD was higher compared to patients without COPD (observed to expected mortality ratio with 95% CI 0.91 (0.90 – 0.92) vs 1.14 (1.12 – 1.16), respectively). The presence of COPD was an independent risk factor for increased mortality in multivariable regression. Prolonged mechanical ventilation occurred more common in patients with COPD (24%) compared to those without (13%), p<0.0001. Prolonged weaning was also more common in patients with COPD (6%) compared to those without (2%), p<0.0001. During the course of 11 years the incidence of acute respiratory failure due to COPD increased from 1.8% to 3.0%, p<0.0001) and the use of non-invasive ventilation more than doubled (from 15% to 34%, p<0.0001). Simultaneously, the risk-adjusted mortality of COPD patients improved.Conclusions: Acute respiratory failure due to COPD is an increasingly common condition in critically ill patients. The presence of COPD is associated with increased mortality and morbidity. The improvement of risk-adjusted mortality over time may be attributable to the beneficial effects of non-invasive ventilation.