Two-year survival of severe chronic obstructive pulmonary disease subjects requiring invasive mechanical ventilation and the factors affecting survival

Abstract

Objective: To investigate two-year survival rates and the factors affecting survival in patients of severe chronic obstructive pulmonary disease requiring invasive mechanical ventilation. Methods: The retrospective study was conducted at Yuzuncuy? l University, Van, Turkey, and comprised record of inpatients with moderate to severe chronic obstructive pulmonary disease who required invasive mechanical ventilation in the intensive care unit of the Pulmonary Diseases Department between January 2007 and December 2010. Correlation between survival and parameters such as age, gender, duration of illness, history of smoking, arterial blood gas values, pulmonary artery pressure, left ventricular ejection fraction, body mass index and laboratory findings were investigated. SPSS 19 was used for statistical analysis. Results: Of the 69 severe COPD subjects available, 20 (29%) were excluded as they did not meet the inclusion criteria. Overall in-hospital mortality rate was 42%(n: 29). Of the remaining 20 (29%) who comprised the study group, 14(70%) were men and 6(30%) were women. The mortality rates at the end of 3rd, 6th, 12th and 24th months were 61%, 76%, 84% and 85.5% respectively. There was no correlation between gender and survival in time point (p> 0.05). The only factor that affected the rate of mortality at the end of the 3rd month was age (p< 0.05). Mortality was high in subjects with advanced ages (p< 0.05). Duration of illness affected the survival at the end of the six month (p< 0.05). Survival rates were high in subjects with longer illness durations (p< 0.05). Haematocrit level was the only factor that affected mortality rates at the end of 12th and 24th months (p< 0.05). Subjects with higher haematocrit levels had higher survival rates (p< 0.05). Conclusion: Age, duration of illness and haematocrit levels were the most important factors that affected survival in chronic obstructive pulmonary disease patients requiring mechanical ventilation.