Factors affecting the annual exacerbation frequency of patients hospitalized with chronic obstructive pulmonary disease exacerbation

This study is a retrospective study conducted to examine the risk factors for COPD exacerbation and hospitalization. Patients hospitalized with the diagnosis of COPD exacerbation between January 1 and March 31, 2018 in Muğla Sıtkı Koçman University Chest Diseases Clinic were investigated for severe exacerbation within one year after discharge. One hundered one patients were included in the study, a total of 63 patients were evaluated, 38 of which were excluded due to exclusion criteria. The study data was obtained from the patient files, and the missing information was obtained by phone call. The patients hospitalized with relapse were named as Group 1, and those who were not hospitalized as Group 2. General demographics, clinical, laboratory and radiological findings of the patients were recorded. Apart from the patients hospitalized with exacerbation, presence of exacerbation, admission to the emergency roomdue to exacerbation (Group 3-4) and factors affecting mortality were also investigated. The frequency of exacerbations and hospitalizations, frequency of emergency admissions and total number of exacerbations and clinical demographic data were compared. It was found that 73% (n = 46) of the patients had an emergency admission and / or hospitalization with exacerbation, and 54% were hospitalized with exacerbation. It was seen that 44.4% of them died. In our study, it was found that the patients with lower FVC values (p = 0.007), body mass index below 25 (p = 0.034), and depressive disorders (p = 0.010) were more frequently hospitalized with severe exacerbation. In patients with lower body mass index (p = 0.020), longer hospital stay (p = 0.026), PaCO2 above 45 mmHg (p = 0.002), Lactate 2 and above (p = 0.021), and cardiovascular disease (p = 0.008) mortality was higher. Lower platelet values (p = 0.021) and higher CRP (p = 0.015) levels were observed in those who applied to the emergency room with exacerbation. In conclusion, it was found that more than half of the patients hospitalized with a second exacerbation and the mortality of these patients was high within 2 years. Patients with low FVC values and normal or low BMI were found to be at risk for severe exacerbation. Carbon dioxide retention, low BMI, length of hospital stay, Lactate levels and LDH levels were also found to be factors affecting mortality. Inour study, it has been observed that the risk of re-exacerbation and mortality of patients hospitalized with COPD exacerbation are high. It is thought that a multidisciplinary approach such as effective pulmonary rehabilitation, close follow-up, review of pharmacological, non-pharmacological treatments, and treatment of comorbidities are required in these patients.