THE PREDICTIVE FACTORS FOR MORTALITY RISK IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT THE RESPIRATORY DEPARTMENT OF CHO RAY HOSPITAL
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Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality worldwide, resulting in an increasing socio-economic burden. As one of the most common non-infectious respiratory diseases, COPD affects up to 300 million people globally1, with a prevalence rate of approximately 13,1% worldwide2. In 2019, COPD was recorded as the third leading cause of death globally, accounting for approximately 3,3 million deaths, which represents 81,7% of all respiratory-related mortalities1. An acute exacerbation of COPD (AECOPD) is characterized by a worsening of respiratory symptoms requiring additional treatment. Severe AECOPD cases, requiring hospitalization or emergency department admission, indicate a critical deterioration of the condition3. Identifying independent predictors of mortality in patients with AECOPD is a crucial necessity. Objective: To identify independent factors predicting mortality risk in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Subjects and Methods: A retrospective study, we collected patients were diagnosed with acute exacerbation of COPD (AECOPD) admitted to the Respiratory Medicine Department of Cho Ray Hospital from January 2024 to June 2024. Results: Our study included 124 hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Mortality rate was 12,1%, invasive mechanical ventilation rate: 37,1%. Intensive care unit (ICU) admission rate: 41,9%. Median age was 70.3 years. Male patients predominate in the study population: 952%. Among the 124 patients, 42,7% had a history of hospitalization due to exacerbation within the past year; and 18,5% had received antibiotic treatment within the three months before admission. The most common comorbidities were hypertension and Type 2 diabetes mellitus. Positive sputum cultures were found in 23,4% of patients, with Acinetobacter baumannii being the most frequently isolated pathogen. Independent predictors of mortality in AECOPD patients include: history of hospitalization due to exacerbation within the past year (OR = 13,1; 95% CI: 11,05-15,16), elevated C-reactive protein (CRP) levels (OR = 1,02; 95% CI: 1,005-1,035), Neutrophil-to-Lymphocyte Ratio (NLR) (OR = 1,046; 95% CI: 1,01-1,08). Conclusion: A history of hospitalization due to exacerbation within the past year, elevated C-reactive protein (CRP) levels, and a high Neutrophil-to-Lymphocyte Ratio (NLR) are independent predictors of in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Article Details
Keywords
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD), Mortality risk
References

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