TABLE 1.
Patient characteristics and comparison between severe AECOPD survivors and nonsurvivorsa
| Characteristic | Total (n = 25) | Nonsurvivors (n = 4) | Survivors (n = 21) | P value |
|---|---|---|---|---|
| Patients’ characteristics at admission to ICU | ||||
| Age | 66 [62 to 72] | 65 [58 to 70] | 66 [62 to 72] | 0.60 |
| Sex (male) | 14 (56%) | 3 (75%) | 11 (52%) | 0.60 |
| Gold score (n = 20) | 0.65 | |||
| 3 | 10 (50%) | 2/3 (67%) | 8/17 (47%) | |
| 4 | 10 (50%) | 1/3 (33%) | 9/17 (53%) | |
| Home oxygen therapy | 13 (52%) | 1 (25%) | 12 (57%) | 0.32 |
| Past tobacco smoking | 25 (100%) | 4 (100%) | 21 (100%) | 1.00 |
| Current tobacco smoking | 7 (28%) | 0 (00%) | 7 (33%) | 0.29 |
| Previous admission to ICU for AECOPD | 11 (44%) | 1 (25%) | 10 (48%) | 0.60 |
| Chronic heart failure | 5 (20%) | 1 (25%) | 4 (19%) | 1.00 |
| Chronic coronary disease | 5 (20%) | 1 (25%) | 4 (19%) | 1.00 |
| Immunosuppression | 3 (12%) | 0 (00%) | 3 (14%) | 1.00 |
| COPD medications | ||||
| Inhaled treatments | ||||
| Β2 agonists | 17 (68%) | 3 (75%) | 14 (66%) | 1.00 |
| Anticholinergics | 16 (64%) | 3 (75%) | 13 (62%) | 1.00 |
| Corticosteroids | 9 (36%) | 3 (75%) | 6 (29%) | 0.12 |
| Dual therapy | 9 (36%) | 0 (00%) | 9 (43%) | 0.26 |
| Triplet therapy | 7 (28%) | 3 (75%) | 4 (19%) | 0.05 |
| Systemic corticosteroids in the previous mo | 5 (20%) | 1 (25%) | 4 (19%) | 1.00 |
| Systemic antibiotics in the previous mo | 6 (24%) | 1 (25%) | 5 (24%) | 1.00 |
| AECOPD presentation | ||||
| SAPS II | 50 [37 to 67] | 57 [55 to 69] | 47 [35 to 54] | 0.06 |
| Heart rate (/min) | 94 [81 to 113] | 120 [85 to 155] | 94 [78 to 107] | 0.14 |
| Systolic blood pressure (mm Hg) | 129 [117 to 152] | 141 [124 to 189] | 129 [115 to 151] | 0.22 |
| Diastolic blood pressure (mm Hg) | 70 [64 to 80] | 75 [62 to 103] | 70 [59 to 78] | 0.46 |
| Respiratory rate | 28 [20 to 33] | 28 [26 to 33] | 28 [20 to 33] | 0.82 |
| Accessory muscles activation | 17 (68%) | 2 (50%) | 15 (71%) | 0.57 |
| pH | 7.25 [7.15 to 7.31] | 7.27 [7.15 to 7.34] | 7.25 [7.15 to 7.31] | 0.94 |
| PaCO2 (kPa) | 9.9 [8.2 to 13.1] | 7.8 [7.62 to 8.8] | 10.2 [8.7 to 14.0] | 0.04 |
| PaO2 (kPa) | 9.5 [7.9 to 12.5] | 9.2 [7.2 to 14.8] | 9.5 [7.9 to 12.5] | 1.00 |
| Bicarbonates (mmol/L) | 32.4 [28.6 to 35] | 26.2 [22.8 to 31.2] | 34 [30.8 to 36.7] | 0.02 |
| Treatment | ||||
| Noninvasive ventilation at any time | 24 (96%) | 3 (75%) | 21 (100%) | 0.16 |
| Invasive mechanical ventilation | 13 (52%) | 4 (100%) | 9 (43%) | 0.09 |
| Tidal volume (mL/kg of ideal body wt) | 6.8 [6.2 to 7.8] | 7.2 [6.6 to 9.2] | 6.5 [5.9 to 7.9] | 0.40 |
| Ventilation rate (/min) | 24 [19 to 26] | 25 [23 to 27] | 24 [19 to 27] | 0.55 |
| Inspired fraction of O2 (%) | 32 [25 to 40] | 40 [30 to 55] | 30 [25 to 40] | 0.35 |
| Positive end expiratory pressure (cmH20) | 6 [5 to 6] | 7 [5 to 11] | 5 [5 to 6] | 0.15 |
| Neuromuscular blockade | 4/13 (31%) | 2/4 (50%) | 2/9 (22%) | 0.22 |
| Outcomes | ||||
| Day 28 mortality | 4 (16%) | 4 (100%) | 0 (0%) | |
| Length of noninvasive ventilation (days) | 4 [3 to 6] | 10 [4 to 11] | 4 [3 to 6] | 0.07 |
| Length of invasive ventilation (days) | 5 [4 to 13] | 43 [12 to 52] | 5 [4 to 6] | 0.05 |
| ICU length of stay (days) | 8 [4 to 11] | 51 [13 to 62] | 7 [5 to 9] | 0.06 |
| Hospital length of stay (days) | 14 [8 to 26] | 72 [18 to 95] | 11 [8 to 20] | 0.18 |
a
The results are presented as proportions for categorical variables and median [interquartile range] for continuous variables The P values are for comparison between survivors and nonsurvivors. The threshold for statistical significance was P = 0.05. AECOPD, acute exacerbation of chronic obstructive pulmonary disease; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; PaCO2, carbon dioxide arterial partial pressure; PaO2, dioxygen arterial partial pressure; SAPS II, simplified acute physiology score II.