| Determination of short prognosis among chronic obstructive lung disease with acute respiratory failure according to simplified acute physiology score. |
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Sang Pyo Lee, Yun Up Sung, Sang Hoon Kim, Bong Sik Kim, Young Jun Kim, In Won Park, Byung Whui Choi, Sung Ho Hue |
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Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea |
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| Abstract |
Background
Physician’s estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition, clinical decisions frequentIy reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficult based on the available clinical or paraclinical data at the time of admission.
Method
In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females) , who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine the prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population AlI patients were treated with similar regimen during the hospitalization.
Results
The results were as follows:
1) Hospital mortality was 34% (25 / 74 patients) and surival rate was 66% (49 / 74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age.
2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis.
3) The SAPS at admission was higher in those patients who expired (10.8) than the survived (6. 5), and there was positive correlation between SAPS and mortality (r=0. 91, p < 0. 05) 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate.
Conclusion
In conclusion, the SAPS migBt have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure. |
| Key Words:
Chronic obstructive lung disease with acute respiratory failure Acute Simplified Physiology Score |
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