Predictors of mortality in acute exacerbation of chronic obstructive pulmonary disease

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Many people suffer from this disease for years and die prematurely from it or its complication. COPD is the fourth leading cause of death in the world, and further increase in its prevalence and mortality can be predicted in coming decades. The aim of this work is to study and evaluate predictors of mortality in patients of acute exacerbation of COPD. Materials and Methods: We prospectively included in the study all patients who had been attended for an acute exacerbation of COPD in patient department of TB and respiratory diseases, UNS ASMC,Jaunpur during oct 2021 to 2 feb 2022. An exacerbation was defined by the presence of an increase in at least two of the three following symptoms: dysponea, cough, and sputum purulence severe enough to warrant hospital admission. All patients were documented cases of COPD with prior pulmonary function test conformation (FEV1/FVC<0.7) with irreversible airway obstruction and had been receiving a combination of various bronchodilators. During hospital admission, patients were treated with a standard protocol consisting of the IV administration of corticosteroids (in a standardized dosage of 0.5 mg/kg), theophylline, and nebulised salbutamol and ipratropium bromide as bronchodilating agents, O2 was titrated according to the results of blood gas analyses. Results: 92 patients taken in study out of which 80 survived and 12 were expired during hospital stay. So in this study mortality rate of acute Exacerbation of COPD was 13.04% during hospital stay. Out of 92 patients taken in study, only 8 patients (8.6%) were smoker as well had other risk factor while 58 (63.04%) smoker did not have any other risk factor. 16 patients (17.4%) who were non smoker, had other non smoking risk factors like post tuberculosis bronchlectasis, biomass fuel, Occupational exposer, etc. Conclusion: Predictor of mortality in acute exacerbation of chronic obstructive pulmonary disease at the time of admission are age of patient at the time of admission is mortality predictor in patients of acute exacerbation of COPD. Higher the age of patient, more is the risk of mortality during hospital stay. Amount of smoking in pack years is predictor of mortality. Higher the pack year of smoking more is the risk of mortality during hospital stay. Total duration of illness is a predictor of mortality in patients with acute exacerbation of COPD. More the chronic disease more is mortality.