Hypotension is a predictor of mortality in acute exacerbations of chronic obstructive pulmonary disease.
OBJECTIVE
To identify variables that predict the in-hospital course and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).


METHODS
A retrospective analysis of 94 patients (20 females) with AECOPD. Twenty-one variables including arterial blood gas studies were analysed.


RESULTS
The mean age was 61.2 years. The in-hospital mortality rate was 12.8%; 28.6% of patients required invasive mechanical ventilation and 37.2% required ICU care. In univariate analysis, aypotension at presentation (systolic blood-pressure < 90 mmHg) [p = 0.002, odds ratio OR 10.95, 95% confidence interval (CI) 1.90-63.00); central cyanosis (p = 0.007, OR 6.91, 95% CI 1.42-33.59); and cor-pulmonale (p = 0.009, OR 10.46, 95% CI 1.26-86.46) were univariately associated with in-hospital mortality. On multivariate analysis, hypotension (p = 0.049, OR 18.419, 95% CI 1.013-334.752) remained the only independent predictor.


CONCLUSIONS
More than the markers of poor gas exchange, the presence of hypotension indicates a poor in-hospital prognosis in AECOPD.
Chandra
Divay
D
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India. divayc@bcm.tmc.edu
Guntupalli
Kalpalatha K
KK
Guleria
Randeep
R
D000368:Aged; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007022:Hypotension / Q000150:complications*; D007194:India; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome