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Vol. 40. Issue 7.
Pages 295-300 (July 2004)
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Vol. 40. Issue 7.
Pages 295-300 (July 2004)
Original Articles
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In-Hospital and 2-Year Survival of Patients Treated With Mechanical Ventilation for Acute Exacerbation of COPD
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J.M. Rauricha,
Corresponding author
jmraurich@hsd.es

Correspondence: Dr. J.M. Raurich. Servicio de Medicina Intensiva. Hospital Universitario Son Dureta. Andrea Doria, 55. 07014 Palma de Majorca. España
, J. Péreza, J. Ibáñeza, S. Roiga, S. Batleb
a Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, Palma de Majorca, Spain
b Servicio de Neumología, Hospital Universitario Son Dureta, Palma de Majorca, Spain
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Objective

TO analyze in-hospital and 2-year survival of patients who require mechanical ventilation with intubation after acute respiratory failure due to exacerbation of chronic obstructive pulmonary disease (COPD). The secondary objective was to identify the prognostic factors for in-hospital mortality and mortality at 2 years.

Patients and methods

We retrospectively studied 101 patients with suspected COPD admitted to the intensive care unit between July 1993 and December 1998. Variables potentially related to mortality were analyzed with a univariate model and by logistic regression.

Results

In-hospital survival was 74.3% and 2-year survival was 55.4%. Survival at 2 years was 81% for patients discharged from hospital. The variables associated with in-hospital mortality were age greater than 65 years, electrocardiographic diagnosis of chronic cor pulmonale, and development of multiorgan dysfunction syndrome. No factors predictive of mortality at 2 years were identified.

Conclusions

The in-hospital survival rate for patients with an acute exacerbation of COPD who require mechanical ventilation is good and the 2-year survival rate is acceptable. Age, electrocardiographic signs of cor pulmonale, and development of multiorgan dysfunction syndrome were associated with greater risk of in-hospital mortality.

Key Words:
COPD
Mortality
Mechanical ventilation
Prognosis
Objetivo

Analizar la supervivencia hospitalaria y a los 2 años de los pacientes con insuficiencia respiratoria aguda, debida a una enfermedad pulmonar obstructiva crónica (EPOC) agudizada, tratados con ventilación mecánica invasiva. Los objetivos secundarios fueron identificar los factores pronósticos de la mortalidad hospitalaria y a los 2 años.

Pacientes Y Métodos

Se estudió retrospectivamente a 101 pacientes con sospecha de EPOC tratados en la unidad de cuidados intensivos de un hospital universitario entre julio de 1993 y diciembre de 1998. Se realizaron un análisis univariado y otro de regresión logística de las posibles variables relacionadas con la mortalidad.

Resultados

La supervivencia hospitalaria fue del 74,3% y a los 2 años del 55,4%. La supervivencia a los 2 años fue del 81% para los pacientes dados de alta del hospital. Las variables asociadas con la mortalidad hospitalaria fueron la edad superior a los 65 años, el diagnóstico electrocardiográ-fico de cor pulmonale crónico y el desarrollo de un síndrome de disfunción multiorgánica. No se identificaron factores predictores de mortalidad a los 2 años.

Conclusiones

Los pacientes con EPOC agudizada que requieren ventilación mecánica tienen una supervivencia hospitalaria buena y una supervivencia a los 2 años acepta-ble. La edad, la presencia de signos electrocardiográficos de cor pulmonale y el desarrollo de síndrome de disfunción multiorgánica se asociaron a una mayor mortalidad hospitalaria.

Palabras clave:
EPOC
Mortalidad
Ventilación mecánica
Pronóstico
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Financed in part by RED GIRA, G 03/63, Instituto Carlos m, Madrid, Spain.

Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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