Difficult to manage COPD Exacerbations: Risk factors (DIMECO Study). Turkish Thoracic Society COPD Assembly

Abstract

Aim: Our aim is to determine the risk factors for patients whose clinical stability can not be reached or whose can not be discharged with the optimal care.

Material-Method: It is a multicenter, prospective observational study. 434 patients who were hospitalized (non-ICU) with severe exacerbation were included in the study. The primary endpoint for "difficult-to-manage COPD exacerbation" is prolonged hospitalization (PH). Hospitalizations of >8 days accepted as PH. To identify risk factors and to develop a scoring system that predicts PH.

Results: 361 (83.2%) of the patients are male and the mean age is 69.2±9.3 year. 285 (67.2%) of the patients are in the GOLD-D group. There was prolonged hospitalization in 237 patients (54.6%). The factors related with PH are smoking,pathological X-ray,GOLDgroup C/D,high CRP, HAP,requiriment of NIV/parenteral nutrition,delaying examination. A combined scoring system that can predict the odds of PH is shown in Table1. The risk of PH increases 4 times in patients who score ≥3 (OR:3.9, 95%GA 2.5-61,P>0.001).

Conclusion: Factors that can be related with PH for the COPD exacerbations should be evaluated in terms of patient, disease and hospital dynamics. We think that the scoring system developed in this study can be used to predict PH and therefore diffucult to manage COPD.