[Prognosis for acute exacerbation of chronic obstructive pulmonary disease in mechanically ventilated patients].
OBJECTIVE
To determine the variables associated with prognosis for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in mechanically ventilated patients.


METHODS
Prospective cohort study with retrospective analysis.


METHODS
361 Intensive Care Units (ICU) in 20 countries.


METHODS
There were included in the study 522 patients who required mechanical ventilation for more than 12 hours due to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In order to determine those variables associated with mortality, there was performed a recursive partition analysis in which the following variables were included: demographics, arterial blood gas prior to intubation, complications arising during mechanical ventilation (barotrauma, acute respiratory distress syndrome, ventilator-associated pneumonia, sepsis), organ dysfunction (cardiovascular, renal, liver, coagulation) and duration of ventilatory support.


METHODS
None. VARIABLES OF PRIME IMPORTANCE: ICU mortality.


RESULTS
ICU and hospital mortality rates were 22% and 30%, respectively. Variables associated with mortality were cardiovascular dysfunction, renal dysfunction and duration of ventilatory support > 18 days. Median durations were as follows: mechanical ventilatory support, 4 days (P25: 2, P75: 6); weaning from ventilatory support, 2 days (P25: 1, P75: 5); stay in intensive care unit, 8 days (P25: 5, P75: 13); stay in hospital, 17 days (P25: 10, P75: 27).


CONCLUSIONS
Mortality in the studied cohort of patients with AECOPD was associated with cardiovascular dysfunction, renal dysfunction and prolonged mechanical support.
Frutos-Vivar
F
F
Unidad de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, España. ffrutos@ucigetafe.com
Esteban
A
A
Anzueto
A
A
Apezteguia
C
C
González
M
M
Bugedo
G
G
D'Empaire
G
G
Palizas
F
F
Elizalde
J
J
Soto
L
L
David
C M
CM
Rodrigo
C
C
D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies