Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2017.58.395
Anemia, hypoalbuminemia, and elevated troponin levels as risk factors for respiratory failure in patients with severe exacerbations of chronic obstructive pulmonary disease requiring invasive mechanical ventilation
Gordana Pavliša
; Clinical Center for Pulmonary Diseases “Jordanovac”, UniversityHospital Center Zagreb, Zagreb,Croatia
Marina Labor
orcid.org/0000-0001-5216-8129
; Department of Pulmonology University Hospital Center Osijek,Osijek, Croatia
Hrvoje Puretić
; Clinical Center for Pulmonary Diseases “Jordanovac”, UniversityHospital Center Zagreb, Zagreb,Croatia
Ana Hećimović
; Clinical Center for Pulmonary Diseases “Jordanovac”, UniversityHospital Center Zagreb, Zagreb,Croatia
Marko Jakopović
; Clinical Center for Pulmonary Diseases “Jordanovac”, UniversityHospital Center Zagreb, Zagreb,Croatia
Miroslav Samaržija
; Clinical Center for Pulmonary Diseases “Jordanovac”, UniversityHospital Center Zagreb, Zagreb,Croatia
Sažetak
Aim To determine in-hospital and post-discharge mortality,
readmission rates, and predictors of invasive mechanical
ventilation (IMV) in patients treated at intensive care
unit (ICU) due to acute exacerbations of chronic obstructive
pulmonary disease (AECOPD).
Methods A retrospective observational cohort study included
all patients treated at a respiratory ICU for AECOPD
during one year. A total of 62 patients (41 men) with mean
age 68.4 ± 10.4 years were analyzed for outcomes including
in-hospital and post-discharge mortality, readmission
rates, and IMV. Patients’ demographic, hematologic, biochemical
data and arterial blood gas (ABG) values were recorded
on admission to hospital. Mean duration of followup
time was 2.4 years.
Results Of 62 patients, 7 (11.3%) died during incident hospitalization
and 21 (33.9%) died during the follow-up. The
overall 2.4-year mortality was 45.2%. Twenty nine (46.8%)
patients were readmitted due to AECOPD. The average
number of readmissions was 1.2. Multivariate analysis
showed that blood pH, bicarbonate levels, low albumin,
low serum chloride, and low hemoglobin were significant
predictors of IMV during incident hospitalization (P < 0.001
for the overall model fit).
Conclusion High in-hospital and post-discharge mortality
and high readmission rates in our patients treated due
to AECOPD at ICU indicate that these patients represent
a high risk group in need of close monitoring. Our results
suggested that anemia, hypoalbuminemia, and elevated
troponin levels were risk factors for the need of IMV in
severe AECOPD. Identification of such high-risk patients
could provide the opportunity for administration of an appropriate
and timely treatment.
Ključne riječi
Hrčak ID:
200218
URI
Datum izdavanja:
28.12.2017.
Posjeta: 1.625 *