Introduction. Chronic obstructive pulmonary disease is the fourth leading cause of death worldwide. Acute exacerbations often require hospitalization, and are associated with high mortality. Identifying risk factors associated with mortality may improve medical treatment and reduce mortality. This study aimed to analyze outcomes of patients with acute exacerbations of chronic obstructive pulmonary disease treated in the intensive care unit, and to identify factors associated with mortality. Material and Methods. This retrospective study was conducted at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia, between April 2015 and January 2019. Inclusion criteria were a diagnosis of acute exacerbation of chronic obstructive pulmonary disease, intensive care unit admission, and treatment with invasive mechanical ventilation. Results. A total of 127 patients were included, of whom 79 (62.2%) were male, with mean age (X - ? SD) of 66.96 ? 8.57 years. Intensive care unit mortality was 33/127 (26%), with a mean length of stay of 3.5 days (interquartile range 2.0-8.0). Overall in-hospital mortality was 56/127 (44%), with a median hospital stay of 15.0 days (interquartile range 7.0-24.0). Multivariate analysis identified the PaO2/FiO2 ratio (odds ratio 0.99; 95% confidence interval 0.98- 0.99; p=0.013), Glasgow Coma Score (odds ratio 0.82; 95% confidence interval 0.69-0.96; p=0.014), and presence of septic shock (odds ratio 50.9; 95% confidence interval 8.58-549.52; p < 0.001) as predictors of intensive care unit mortality. Conclusion. Mortality among patients with acute exacerbations of chronic obstructive pulmonary disease treated in the intensive care unit remains high. Reduced PaO2/FiO2 ratio, lower Glasgow Coma Score, and septic shock are independent predictors of mortality.
Brusnjai et al. (Wed,) studied this question.