Aims: This study aims to evaluate the relationship between pulmonary artery/aorta (PA/Ao) ratio and hospital length of stay, disease severity, and clinical outcomes in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A retrospective analysis was conducted on 214 patients admitted with COPD exacerbation between May 2022 and February 2024. Following comprehensive exclusion criteria, 160 patients were included in the final analysis. PA/Ao ratios were measured on thoracic computed tomography images. Hospital length of stay, annual exacerbation frequency, and clinical parameters were evaluated. Statistical analysis employed log-transformation, multivariable regression, and ROC analysis. Results: Mean age was 69.4±9.2 years, with 64.4% being male. Mean PA/Ao ratio was 1.105±0.119. PA/Ao ratio showed significant positive correlation with log-transformed hospital length of stay (β=1.4132, 95% CI: 0.739-2.088, p=0.0001) and annual exacerbation frequency (r=0.296, p=0.0001). Patients with PA/Ao>1.15 had significantly longer hospital stays (7.7±8.0 vs 4.7±3.2 days, p=0.0025) and higher annual exacerbation frequency (1.98±1.28 vs 1.39±0.76, p=0.0003). Multivariable analysis identified PA/Ao ratio and serum lactate level as independent predictors of hospital length of stay (Model R²=0.247). Conclusion: PA/Ao ratio is a reliable predictor of hospital length of stay and disease severity in COPD exacerbations. This non invasive radiological parameter can be utilized in clinical risk stratification and treatment planning.
KOÇ et al. (Mon,) studied this question.