Predictive Factors of Severe COPD Exacerbation

Abstract

<bold>Introduction:</bold> Severe exacerbations of COPD are critical events that significantly impact patient outcomes. Understanding the predictive factors can aid in early intervention and better management of high-risk patients. <bold>Aim:</bold> identify the predictive factors of severe COPD exacerbation <bold>methods:</bold> This was a prospective study conducted at the pneumology department of Charles Nicolle Hospital, Tunis, from December 2017 to December 2021, including patients with COPD followed for one year. A severe exacerbation was defined as an exacerbation requiring non-invasive ventilation. We performed both univariate and multivariate analyses. <bold>Results:</bold> A total of 121 patients were included. The mean age was 67.17 years. The sex ratio was 7.3. The majority of patients were smokers (93.2%). Chronic respiratory failure (CRF) was noted in 51 patients (42%). During the follow-up, 49 patients (40.5%) had a severe exacerbation. In univariate analysis, patients with severe exacerbations had higher CAT scores for dyspnea (23 vs 19, p=0.01), capnia (46 vs 41, p=0.05), platelet-to-lymphocyte ratio (183 vs 133, p=0.01) and BODE scores (6 vs 4, p=0.01). They also had lower FEV1 (35% vs 46%, p<0.001) and lymphocyte counts (1612 vs 2121, p= 0.004). In multivariate analysis, only FEV1 was independently associated with exacerbation severity (OR = 2.03, 95% CI [1.54, 2.78], p = 0.03). <bold>Conclusions:</bold> FEV1 is an important predictor of severe COPD exacerbations and can help identify patients at higher risk for adverse outcomes