title: Prognostic factors in the management of exacerbation of chronic obstructive pulmonary disease in Kuwait.
abstract: OBJECTIVE
  To evaluate the clinical presentation and the factors of prognostic importance in the management of exacerbation of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  One hundred and four patients who were hospitalized because of exacerbation of COPD between 1996 and 2000 were selected for further evaluation. Only patients who fulfilled the American Thoracic Society criteria for diagnosis of COPD were included. The factors examined included age, clinical features, duration of symptoms of exacerbation, severity of underlying disease, comorbid diseases, level of consciousness, previous hospitalization, intubation and assisted ventilation, hypercapnia, degree of acidemia and complications.
  
  
  RESULTS
  Seventy-four of 104 (71%) hospitalized patients reviewed met the inclusion criteria for COPD. The mean age was 63.68 +/- 12.6 years. There was a male:female ratio of 3:1. Fifty-eight patients (78%) had a baseline FEV1 <50% before hospitalization and 45 (64%) had previous hospitalization. Comorbid disease was found in 50% of the cases, while 78% had acidemia and 70% hypercapnia. Fourteen (19%) died on admission. Risk factors identified included severity of disease (p < 0.05); presence of comorbid disease (p < 0.01); acidemia (p < 0.0001); hypercapnia (p < 0.0001); previous hospitalization (p < 0.01), and assisted ventilation (p < 0.001).
  
  
  CONCLUSIONS
  This study revealed that the presence of comorbid disease, acidemia, previous hospitalization and assisted ventilation significantly contributed to mortality in patients with exacerbation of COPD.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait. onadeko@hotmail.com
authors.forename: B O
authors.initials: BO
authors.lastname: Onadeko
authors.forename: M
authors.initials: M
authors.lastname: Khadadah
authors.forename: N
authors.initials: N
authors.lastname: Abdella
authors.forename: M
authors.initials: M
authors.lastname: Mukhtar
authors.forename: M
authors.initials: M
authors.lastname: Mourou
authors.forename: M
authors.initials: M
authors.lastname: Qurtom
authors.forename: M
authors.initials: M
authors.lastname: Samad
authors.forename: A
authors.initials: A
authors.lastname: Al-Shayeb
mesh_terms: D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate