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The prognostic variables predictive of mortality in patients with an exacerbation of COPD admitted to the ICU: an integrative review

Lookup NU author(s): Dr Simon Baudouin

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Abstract

Methods: An integrative review was structured to incorporate a five-stage review framework to facilitate data extraction, analysis and presentation. The quality of the studies contributing to the integrative review was assessed with a novel scoring system developed from previously published data and adapted to this setting.Results: The integrative review search strategy identified 28 studies assessing prognostic variables in this setting. Prognostic variables associated with intermediate-term mortality were low Glasgow Coma Scale (GCS) on admission to ICU, cardio-respiratory arrest prior to ICU admission, cardiac dysrhythmia prior to ICU admission, length of hospital stay prior to ICU admission and higher values of acute physiology scoring systems. Premorbid variables such as age, functional capacity, pulmonary function tests, prior hospital or ICU admissions, body mass index and long-term oxygen therapy were not found to be associated with intermediate-term mortality nor was the diagnosis attributed to the cause of the AECOPD.Discussion: Variables associated with intermediate-term mortality after AECOPD requiring ICU admission are those variables, which reflect underlying severity of acute illness. Premorbid and diagnostic data have not been shown to be predictive of outcome. A scoring system is proposed to assess studies of prognosis in AECOPD.


Publication metadata

Author(s): Messer B, Griffiths J, Baudouin SV

Publication type: Review

Publication status: Published

Journal: QJM: An International Journal of Medicine

Year: 2012

Volume: 105

Issue: 2

Pages: 115-126

Print publication date: 01/02/2012

Online publication date: 09/11/2011

ISSN (print): 1460-2725

ISSN (electronic): 1460-2393

Publisher: OXFORD UNIV PRESS

URL: http://dx.doi.org/10.1093/qjmed/hcr210

DOI: 10.1093/qjmed/hcr210


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