Volume 28, Issue 153, November 2024

Prognostic factors and outcomes in patients with acute COPD exacerbation in intensive care unit: Systematic review

Qais Zaid Alhamdan¹, Amirah Ahmed Dheyab Sharif², Abdulaziz Mazyad Alghonaim³, Mohammed Abdullah Alarbash³, Abdulaziz Abdullah Alayed³, Mutaz Ibrahim O Aljuaid³, Mohammed Mesfer Almalki³

¹Emergency and Intensive Care Unit Consultant, First Health Cluster, King Saud Medical City, Riyadh, Saudi Arabia
²Saudi Board Intensive Care Unit Resident, Intensive Care Department, First Health Cluster, King Saud Medical City, Riyadh, Saudi Arabia
³Saudi Board Intensive Care Unit Resident, Intensive Care Department, Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia

ABSTRACT

Background: Chronic obstructive pulmonary disease is one of the common causes of death worldwide and is a common lung illness that causes respiratory failure in adults. This study aimed to investigate prognostic variables and mortality in COPD patients admitted to the intensive care unit. Method: The PRISMA standards were followed in the conduct of this investigation, and the systematic review included electronic searches of MEDLINE, Embase, Cochrane Library, CINAHL, and Web of Science. We combined COPD-related search terms with prognostic factors, triggers, clinical outcomes, and research design. We looked through electronic databases for English-language publications from 2013 to 2023 that described acute COPD exacerbation in patients admitted to the intensive care unit. Result: In our study, the mean age range of patients is 67.3 to 84. The range of hospital mortality is 11.5% to 29%. The following prognostic factors were examined: age, initial CRP greater than 7.5 mg/dL, elevated BUN, decreased MAP, intubation incident, and use of vasopressors, persistent cardiac failure, less than 0.8 × 109/L for lymphocytes, less than 4 × 109/L for white blood cells, male gender, and less than 88% SpO2 in the first 24 hours. Conclusion: Variables associated with hospital mortality were advanced age, high initial CRP, low peak ENR on days 8–14 of treatment, lymphocytes fewer than 0.8×109/L, leukopenia, need for invasive mechanical ventilation, CHF, and in-hospital comorbidities among patients with acute COPD exacerbations requiring ICU admission.

Keywords: Chronic obstructive pulmonary disease, prognostic variables, mortality, intensive care unit

Medical Science, 2024, 28, e135ms3462

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DOI: https://doi.org/10.54905/disssi.v28i153.e135ms3462

Published: 09 November 2024