title: COPD exacerbation: mortality prognosis factors in a respiratory care unit.
abstract: OBJECTIVE
  The aim of our study was to investigate the mortality predictive factors after a severe exacerbations of COPD admitted to a Spanish respiratory intermediate care unit (IRCU).
  
  
  METHODS
  Prospective observational 2 years study, where we included all episodes of acute exacerbations of COPD with hypercapnic respiratory failure admitted in an IRCU. We analyzed different sociodemographic, functional and clinical variables including physical activity.
  
  
  RESULTS
  We collected data from 102 consecutive episodes admitted to IRCU (90.1% men). Mean age was 69.4±10.6. The mean APACHE II was 19.6±5.0 and 9.5% presented a failure of other non respiratory organ. Non invasive ventilation was applied in 75.3% of the episodes and this treatment failed in 11.6% of them. The duration of stay in the IRCU was 3.5±2.1 days and 8.0±5.3 days in the hospital. The hospital mortality rate was 6.9%, and another 12.7% after 90 days of discharged. In order to predict hospital mortality, multivariant statistics identified a model with AUC of 0.867, based in 3 variables: the number of previous year admission for COPD exacerbation (p=0,048), the respiratory rate after 2 hours of treatment in the IRCU (p=0.0484) and the severity of the disease established with ADO score (p=0.0241).
  
  
  CONCLUSIONS
  The number of previous year admission for COPD exacerbation, the severity of the disease established with ADO score, the respiratory rate after 2 hours of treatment, allow us to identify what patients with a COPD exacerbation admitted in a IRCU can die during this episode.
authors.affiliation: Servicio de Neumología, Hospital de Galdakao, Galdakao, Bizkaia, Spain. myriam.aburtobarreneche@osakidetza.net
authors.forename: Myriam
authors.initials: M
authors.lastname: Aburto
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Esteban
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Moraza
authors.forename: Urko
authors.initials: U
authors.lastname: Aguirre
authors.forename: Mikel
authors.initials: M
authors.lastname: Egurrola
authors.forename: Alberto
authors.initials: A
authors.lastname: Capelastegui
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D012124:Respiratory Care Units; D012720:Severity of Illness Index