@article {Matkovic197, author = {Zinka Matkovic and Marc Miravitlles and Nestor Soler and Arturo Huerta and Rebeca Domingo and Albert Gabarrus and Antoni Torres}, title = {Predictors of poor outcome in severe hospitalised COPD exacerbations}, volume = {38}, number = {Suppl 55}, elocation-id = {197}, year = {2011}, publisher = {European Respiratory Society}, abstract = {Background: The aim of study was to determine predictors of poor outcome in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (ECOPD).Methods: Hospitalised patients with ECOPD were included in a prospective study and followed for 1 month. Clinical and epidemiological parameters were evaluated including COPD Severity Score (COPD-SS) and Charlson Index. Poor outcome was: death, intensive care unit (ICU) admission, need for mechanical ventilation (MV), prolonged hospital stay (\>11 days) and emergency room (ER) visit/readmission during follow-up.Results: 155 patients: mean age{\textpm}standard deviation 70{\textpm}9.5yrs; 84\% men; 96\% smokers/ex-smokers; 76\% GOLD stage III or IV; mean hospital stay 8.8{\textpm}5.5days. 69 patients (45\%) had poor outcome: 4 (3\%) died; 16 (10\%) had ICU admission; 33 (21\%) had MV, 32 (21\%) had prolonged hospital stay and 24 (16\%) had ER visit/readmission during follow-up. Univariate analysis identified variables associated with poor outcome: exacerbations and hospitalisation for ECOPD in the last year (p=0.033 and 0.039 respectively); lower FEV1 (p=0.004); GOLD stage (p=0.049); lower pH (p\<0.001); lower PaO2/FIO2 (p=0.006); higher PaCO2 (p\<0.001); higher COPD-SS (p=0.016); long-term O2 therapy (p=0.042). Independent predictors of poor outcome determined by multivariate analysis: number of exacerbations in the previous year (1 ECOPD: p=0.012, odds ratio [OR] 4.1, 95\% confidence interval [CI] 1.4 to 12.3; >=2 ECOPD: p=0.005, OR 4.4, 95\% CI 1.6 to 12.5); pH (p=0.006, OR 0.2, 95\% CI 0.1 to 0.7); PaCO22 (p=0.015, OR 1.3, 95\% CI 1.1 to 1.7).Conclusion: Previous exacerbations, hypercapnia and respiratory acidosis were identified as predictors of poor outcome in patients with severe ECOPD.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/38/Suppl_55/197}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }