title: Patient Outcome after Chronic Obstructive Pulmonary Disease Exacerbations Requiring Non-invasive Ventilation during Hospitalization.
abstract: BACKGROUND
  Noninvasive ventilation (NIV) during hospitalization for acute hypercapnic exacerbations of chronic obstructive pulmonary disease (COPD) has been shown to be effective, but data on the prognosis of such patients is limited. The aim of this study was to investigate in-hospital and long-term outcome in patients with COPD exacerbations requiring NIV treatment during hospitalization.
  
  
  METHODS
  Between 2011 and 2013, hospitalized subjects with hypercapnic COPD exacerbations were included in this retrospective single-center cohort study. Subjects' clinical and laboratory data and survival status after a median of 27 months were recorded. The predictive factors of in-hospital and long-term mortality were analyzed.
  
  
  RESULTS
  A total of 574 patients (357 men, mean age 68±11 years) were recorded. During hospitalization, 24 (4.1%) patients died. In-hospital mortality was negatively affected by lower baseline values of hematocrit, albumin, and pH, and by higher baseline leucocytes and higher 24h PaCO2. Median survival of the cohort was 27 months. Mortality at 3 and 6 months, and 1 year were 14.5%, 19.5%, and 30%, respectively. In the univariate analysis, reduction in long-term survival was found to be related to older age, higher Charlson score, lower baseline levels of hematocrit and albumin, and lower pH level after 24h. In the multivariate analysis, older age and lower albumin were identified as the strongest predictors of mortality.
  
  
  CONCLUSIONS
  Life expectancy after a COPD exacerbation requiring NIV treatment is short. Baseline blood counts and day 2 arterial blood gases levels may predict in-hospital mortality. The strongest indicators of poorer long-term outcome were advanced age and lower albumin. Such patients may need closer follow-up.
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía. Electronic address: fatmatokgoz86@gmail.com.
authors.forename: Fatma
authors.initials: F
authors.lastname: Tokgoz Akyil
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Hakan
authors.initials: H
authors.lastname: Gunen
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Meltem
authors.initials: M
authors.lastname: Agca
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Sinem
authors.initials: S
authors.lastname: Gungor
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Murat
authors.initials: M
authors.lastname: Yalcinsoy
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Pakize
authors.initials: P
authors.lastname: Sucu
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akyil
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Estambul, Turquía.
authors.forename: Tulin
authors.initials: T
authors.lastname: Sevim
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation; D010102:Oxygen Inhalation Therapy; D010362:Patients' Rooms; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013147:Spirometry; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents
keywords: Arterial blood gas; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Gasometría arterial; Insuficiencia respiratoria; Noninvasive ventilation; Respiratory failure; Ventilación no invasiva