TY - JOUR T1 - Prevalence and prognosis of critically ill patients with COPD between 1998 and 2008 JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2049 AU - Georg-Christian Funk AU - Peter Bauer AU - Otto Chris Burghuber AU - Andreas Fazekas AU - Sylvia Hartl AU - Barbara Metnitz AU - Philip Metnitz Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2049.abstract N2 - 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. ER -