Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study.
BACKGROUND
Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients.


METHODS
We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality.


RESULTS
The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01).


CONCLUSIONS
Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.
Service d'Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France. k.langlet@orange.fr
Ketty
K
Langlet
Thierry
T
Van Der Linden
Claire
C
Launois
Caroline
C
Fourdin
Philippe
P
Cabaret
Nadia
N
Kerkeni
Coralie
C
Barbe
François
F
Lebargy
Gaetan
G
Deslée
D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome