Abstract Background Chronic pulmonary disease (CPD), including chronic obstructive pulmonary disease (COPD), interstitial lung disease, and bronchiectasis, is a major contributor to global morbidity and mortality. CPD patients often experience progressive functional impairment, recurrent hospitalizations, and reduced quality of life. When admitted to the intensive care unit (ICU), they are vulnerable to decline from immobility, inflammation, and critical illness. Prior studies show that pre-existing respiratory disease increases risk of respiratory failure and readmission; its independent effect on short-term outcomes such as ICU and hospital length of stay (LOS) and early functional recovery remains unclear. Functional status at ICU admission, assessed using the Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks,” has emerged as a prognostic indicator. However, few studies have prospectively examined whether CPD independently predicts impaired function or prolonged hospitalization among medical ICU patients. Objective To evaluate whether chronic pulmonary disease is associated with differences in functional status, ICU LOS, and hospital LOS after adjusting for comorbidities and illness severity. Methods We conducted a prospective observational study of 150 adults admitted to a tertiary medical ICU over 3 months. Demographics, comorbidities (Charlson Comorbidity Index), Sequential Organ Failure Assessment (SOFA) score, and AM-PAC “6-Clicks” functional status at ICU admission were recorded. Patients were categorized as with CPD (n = 33, 22%) or without CPD (n = 117, 78%). Continuous variables were compared using Mann-Whitney U tests, and multivariable linear regression adjusted for age, SOFA, and Charlson Index identified independent associations. Results The cohort was 56% male (n = 84) with a mean age of 63 ± 14 years. The most common primary diagnoses were respiratory failure (51%) and sepsis (36%). CPD patients had slightly lower AM-PAC scores than those without CPD (14.8 ± 6.4 vs 15.6 ± 6.2; p = 0.57) and similar ICU (11.4 ± 12.8 vs 10.8 ± 11.0 days; p = 0.87) and hospital LOS (16.8 ± 13.5 vs 17.0 ± 14.2 days; p = 0.74). In adjusted models, CPD was not an independent predictor of AM-PAC (β = 0.38; p = 0.90), ICU LOS (β ≈ 0.6; p 0.7), or hospital LOS (β ≈ 0.5; p 0.6). Conclusions Among medical ICU patients, chronic pulmonary disease was not associated with lower functional status or prolonged hospitalization after adjustment for comorbidities and illness severity. Baseline function may better determine short-term outcomes. Future studies should assess whether early rehabilitation and social-work interventions enhance recovery and post-ICU function in this population. This abstract is funded by: None
Sarver et al. (Fri,) studied this question.