title: [Outcome predictors for COPD patients hospitalized for acute exacerbation].
abstract: BACKGROUND
  Prognostic factors for clinical failure of acute exacerbation in patients with COPD (AECOPD) are of special importance in order to choose an adequate therapy and resources during inpatient treatment. Our database was analyzed to identify predictors for a negative outcome.
  
  
  METHODS
  In a retrospective analysis medical records of 616 patients (299 women; 317 men) hospitalized for AECOPD between January 2011 and January 2016 were analyzed in order to evaluate demographic and clinical parameters leading to adverse events. Only the first admission was considered. Logistic regression analysis was performed to determine the relative risk (odds ratio (OR) leading to severe adverse events such as intensive care unit (ICU) admission, mechanical ventilation (invasive or noninvasive), early readmission to ICU and hospital and death).
  
  
  RESULTS
  An increased risk of an ICU admission was found for patients with a coronary heart disease (OR = 5.734; p = 0.009) and for patients requiring an antibiotic therapy (OR = 11.721; p = 0.003). An increased risk for rehospitalisation and mortality was found for age (OR = 1.034; p = 0.028) and a longer duration of the hospital stay (OR = 1.063; p = 0.042). A lower C‑reactive protein (CRP) level was associated with a lower risk of readmission to the hospital (OR = 0.991; p = 0.03). An increased risk of ventilator therapy was found for patients with chronic heart failure (OR = 6.166; p = 0.02) and sleep apnea syndrome (OR = 6.698; p = 0.003), diabetes (OR = 3.754; p = 0.041) and a long stay in the ICU (OR = 2.018; p = 0.000).
  
  
  CONCLUSIONS
  Comorbidities in patients with AECOPD were found to be a major risk factor for ICU admission and mechanical ventilation. Elderly patients and patients with prolonged hospital stay showed a higher risk for readmission and mortality. Patients with a low CRP blood level seemed to have a lower risk for rehospitalisation.
authors.affiliation: Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland. spielmanns@k-plus.de.|Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland. spielmanns@k-plus.de.
authors.forename: M
authors.initials: M
authors.lastname: Spielmanns
authors.affiliation: Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Axer
authors.affiliation: Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Nell
authors.affiliation: Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland.
authors.forename: A R
authors.initials: AR
authors.lastname: Koczulla
authors.affiliation: Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Boeselt
authors.affiliation: Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.|Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Magnet
authors.affiliation: Universitätsklinikum Freiburg, Freiburg, Deutschland.|Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.
authors.forename: J H
authors.initials: JH
authors.lastname: Storre
authors.affiliation: Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.|Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Windisch
mesh_terms: D000368:Aged; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies
keywords: COPD; Exazerbation; ICU admission; Outcome; Predictors; Rehospitalisation; Ventilator therapy