Tags

Type your tag names separated by a space and hit enter

Derivation of a prognostic equation to predict in-hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease.
Indian J Chest Dis Allied Sci. 2008 Oct-Dec; 50(4):335-42.IJ

Abstract

OBJECTIVE

Predicting in-hospital mortality and formulating a scoring system derived from predictors of mortality may aid prognostication.

METHODS

One hundred and fifty-one consecutive patients admitted with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were followed to discharge or death in hospital stay. Secondary variables studied were duration of hospital stay, and need for and duration of mechanical ventilation (MV).

RESULTS

Mean (SD) age of patients was 60.5 (11.4) years; 65.6% were mechanically ventilated, and 25.2% died in hospital. Independent predictors of mortality at admission were serum creatinine (odds ratio [OR] 2.1, 95% Confidence intervals [CI] 1.03 to 4.30; p = 0.04), and serum sodium (OR 0.94, 95% CI 0.90 to 0.99; p = 0.03). An equation derived [Score = 8+ (0.74 x creatinine) = (0.015 x sodium)] to predict mortality, had an area under receiver operating characteristic (ROC) curve of 73%, with a cut-off of 6.74 having sensitivity, specificity, positive and negative predictive values for predicting death of 71%, 64%, 40% and 87%, respectively. Glasgow coma scale (GCS), partial pressure of oxygen in arterial blood (PaO2) and partial pressure of carbon dioxide in arterial blood (PaCO2) at admission independently predicted need for invasive ventilation. An equation derived [Score = 2.36+(0.02 x PaO2)+(0.05 x PaCO2)-(0.47 x GCS)] to predict need for MV, had an area under ROC curve of 85%, with a cut-off of 0.54 having sensitivity, specificity, positive and negative predictive values for predicting need for MV of 82%, 81%, 89% and 70%, respectively.

CONCLUSIONS

Serum creatinine and sodium at admission are independent predictors of mortality for patients admitted with AECOPD. The equation derived from these two variables is a simple and useful method for predicting outcome.

Authors+Show Affiliations

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19035052

Citation

Mohan, A, et al. "Derivation of a Prognostic Equation to Predict In-hospital Mortality and Requirement of Invasive Mechanical Ventilation in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease." The Indian Journal of Chest Diseases & Allied Sciences, vol. 50, no. 4, 2008, pp. 335-42.
Mohan A, Bhatt SP, Mohan C, et al. Derivation of a prognostic equation to predict in-hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci. 2008;50(4):335-42.
Mohan, A., Bhatt, S. P., Mohan, C., Arora, S., Luqman-Arafath, T. K., & Guleria, R. (2008). Derivation of a prognostic equation to predict in-hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. The Indian Journal of Chest Diseases & Allied Sciences, 50(4), 335-42.
Mohan A, et al. Derivation of a Prognostic Equation to Predict In-hospital Mortality and Requirement of Invasive Mechanical Ventilation in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Indian J Chest Dis Allied Sci. 2008 Oct-Dec;50(4):335-42. PubMed PMID: 19035052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Derivation of a prognostic equation to predict in-hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. AU - Mohan,A, AU - Bhatt,S P, AU - Mohan,C, AU - Arora,S, AU - Luqman-Arafath,T K, AU - Guleria,R, PY - 2008/11/28/pubmed PY - 2009/1/28/medline PY - 2008/11/28/entrez SP - 335 EP - 42 JF - The Indian journal of chest diseases & allied sciences JO - Indian J Chest Dis Allied Sci VL - 50 IS - 4 N2 - OBJECTIVE: Predicting in-hospital mortality and formulating a scoring system derived from predictors of mortality may aid prognostication. METHODS: One hundred and fifty-one consecutive patients admitted with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were followed to discharge or death in hospital stay. Secondary variables studied were duration of hospital stay, and need for and duration of mechanical ventilation (MV). RESULTS: Mean (SD) age of patients was 60.5 (11.4) years; 65.6% were mechanically ventilated, and 25.2% died in hospital. Independent predictors of mortality at admission were serum creatinine (odds ratio [OR] 2.1, 95% Confidence intervals [CI] 1.03 to 4.30; p = 0.04), and serum sodium (OR 0.94, 95% CI 0.90 to 0.99; p = 0.03). An equation derived [Score = 8+ (0.74 x creatinine) = (0.015 x sodium)] to predict mortality, had an area under receiver operating characteristic (ROC) curve of 73%, with a cut-off of 6.74 having sensitivity, specificity, positive and negative predictive values for predicting death of 71%, 64%, 40% and 87%, respectively. Glasgow coma scale (GCS), partial pressure of oxygen in arterial blood (PaO2) and partial pressure of carbon dioxide in arterial blood (PaCO2) at admission independently predicted need for invasive ventilation. An equation derived [Score = 2.36+(0.02 x PaO2)+(0.05 x PaCO2)-(0.47 x GCS)] to predict need for MV, had an area under ROC curve of 85%, with a cut-off of 0.54 having sensitivity, specificity, positive and negative predictive values for predicting need for MV of 82%, 81%, 89% and 70%, respectively. CONCLUSIONS: Serum creatinine and sodium at admission are independent predictors of mortality for patients admitted with AECOPD. The equation derived from these two variables is a simple and useful method for predicting outcome. SN - 0377-9343 UR - https://www.unboundmedicine.com/medline/citation/19035052/Derivation_of_a_prognostic_equation_to_predict_in_hospital_mortality_and_requirement_of_invasive_mechanical_ventilation_in_patients_with_acute_exacerbation_of_chronic_obstructive_pulmonary_disease_ L2 - http://www.diseaseinfosearch.org/result/7979 DB - PRIME DP - Unbound Medicine ER -