Risk factors of mortality in patients with acute exacerbation of chronic obstructive pulmonary disease treated with invasive mechanical ventilation
Objective To analyze the risk factors of mortality in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)treated with invasive mechanical ventilation.Methods 49 cases of patients with AECOPD receiving invasive mechanical ventilation were selected as the study subjects.According to the prognosis,the dead patients were selected as the study group(25 cases)and the surviving patients as the control group(24 cases).The clinical indicators[gender,age,disease course,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,white blood cell count(WBC),absolute value of lymphocytes(LY),procalcitonin(PCT),alanine aminotransferase(ALT),albumin(ALB),serum creatinine(Scr),oxygenation index(P/F),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]of the two groups of patients were collected and compared.Results There were no statistically significant differences in gender,age and Scr between the two groups(P>0.05).APACHE Ⅱ score in the study group was(31.96±1.44)points,PCT was(3.25±2.14)ng/ml,ALT was(367.07±227.36)U/L,NT-proBNP was(4754.41±1275.90)pg/ml,which were higher than those of(20.25±1.11)points,(0.98±0.58)ng/ml,(97.07±42.70)U/L,(2389.96±500.10)pg/ml in the control group;the disease course of(22.44±2.98)years in the study group was longer than that of(14.10±2.02)years in the control group;P/F in the study group was(156.80±20.32)mm Hg(1 mm Hg=0.133 kPa),WBC was(12.39±1.20)×109/L,LY was(0.87±0.18)×109/L,ALB was(34.50±0.97)g/L,which were all lower than those of(194.96±25.84)mm Hg,(14.46±1.41)×109/L,(1.35±0.34)×109/L,(36.33±1.06)g/L in the control group.The difference was statistically significant(P<0.05).Logistic regression analysis showed that long disease course and high ALT and NT-proBNP levels were risk factors for mortality in AECOPD patients receiving invasive mechanical ventilation(OR=1.523,2.476,1.532;P<0.05).Conclusion Long disease course,high ALT and NT-proBNP level are independent risk factors for high mortality in patients with AECOPD receiving invasive mechanical ventilation.
Acute exacerbation of chronic obstructive pulmonary diseaseMechanical ventilationMortality
NETL
NSTL
万方数据
维普
