Hypotension is a predictor of mortality in acute exacerbations of chronic obstructive pulmonary disease.

ABSTRACT

OBJECTIVES: To identify variables that predict the in-hospital course and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A retrospective analysis of 94 patients (20 females) with AECOPD. Twenty-one variables including arterial blood gas studies were analysed. RESULTS: The mean age was 61.2 years. The in-hospital mortality rate was 12.8%; 28.6% of patients required invasive mechanical ventilation and 37.2% required ICU care. In univariate analysis, aypotension at presentation (systolic blood-pressure < 90 mmHg) [p = 0.002, odds ratio OR 10.95, 95% confidence interval (CI) 1.90-63.00); central cyanosis (p = 0.007, OR 6.91, 95% CI 1.42-33.59); and cor-pulmonale (p = 0.009, OR 10.46, 95% CI 1.26-86.46) were univariately associated with in-hospital mortality. On multivariate analysis, hypotension (p = 0.049, OR 18.419, 95% CI 1.013-334.752) remained the only independent predictor. CONCLUSIONS: More than the markers of poor gas exchange, the presence of hypotension indicates a poor in-hospital prognosis in AECOPD.