title: Long-term outcome of chronic obstructive pulmonary disease patients with acute respiratory failure following intensive care unit discharge in Turkey.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) remains a globally significant cause of mortality, although COPD mortality varies from country to country, and across different regions within each country. The primary objective of this study was to determine the mortality rates of COPD patients who present with acute respiratory failure (ARF) to a tertiary care referral center in different stages of their follow-up (ICU, in-hospital and after discharge). The secondary objective was to determine factors associated with mortality in this group of patients.
  
  
  RESULTS
  Medical records of consecutive COPD patients over a 10-year period were reviewed.The study included 147 patients. Of these, 72 were treated initially with noninvasive positive pressure ventilation (NIPPV), and 12 of these required intubation after NIPPV failed. Therefore, 86 patients were intubated for invasive mechanical ventilation (IMV), while NIPPV was succesful in 60 patients. Survival time was independently associated with advanced age, high APACHE II score, co-morbidity and the need for IMV. The cumulative mortality was 27% in the medical ICU and 31% in hospital following ICU discharge. The mortality rate at 1, 2 and 5 years was 54%, 66% and 84%, respectively.
  
  
  CONCLUSIONS
  COPD patients admitted to the ICU for ARF have an approximately 70% chance of leaving hospital alive, but half of these may die in the first 6 months after discharge. The risk factors related to mortality were advanced age, high APACHE II score, co-morbidity and IMV requirement.
authors.affiliation: Hacettepe University, Faculty of Medicine, Medical Intensive Care Unit, Ankara, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Ocal
authors.affiliation: Hacettepe University, Faculty of Medicine, Medical Intensive Care Unit, Ankara, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ortac Ersoy
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Chest Diseases, Ankara, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Preventive Oncology, Ankara, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.affiliation: Hacettepe University, Faculty of Medicine, Medical Intensive Care Unit, Ankara, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Topeli
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Chest Diseases, Ankara, Turkey.
authors.forename: Lutfi
authors.initials: L
authors.lastname: Coplu
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D063087:Noninvasive Ventilation / Q000009:adverse effects* / Q000379:methods; D010351:Patient Discharge / Q000592:standards; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: acute-COPD-exacerbations-intensive care unit-mortality-respiratory failure