Abstract:

Objectives: Chronic obstructive pulmonary disease (COPD) is a difficult chronic illness to manage because it causes prolonged hospital admissions and repeated applications. We aimed to examine the factors affecting this situation in a winter emergency in a chest diseases emergency. Material and Method: We conducted a retrospective study in our emergency department (ED) with patients who admitted due to COPD exacerbations. Factors affecting hospitalization and ICU requirement were evaluated. Results: Totally 128 patients were included. Mean number for ED admissions was 3.01±2.1. There were 73 (57%) hospitalized patients and 17(13.3%) patients transferred to intensive care unit (ICU). White blood cell (WBC) and C reactive protein (CRP) were significantly higher in patients with ≥3 ED admissions than others (p=0.06 and p=0.007 respectively). Among categorical variables being current smoker, long time oxygen therapy (LTOT) and non-invasive mechanical ventilation (NIMV) devices and existence of bronchiectasis were related to frequent ED admission (p=0.025, p=0.01, p=0.046 and p=0.028 respectively). Existence of pneumonia and comorbidities had positive and significant correlations with hospitalization (r=0.18, p=0.04 and r=0.26, p=0.02). In terms of ICU requirement, pneumonia, partial arterial pressure of carbon dioxide (PaCO2) value and mean pulmonary arterial pressure (PAB) had significant correlations (r=0.27, p=0.001, r=0.34, p<0.001 and r=0.24, p=0.006 respectively). Conclusion: The correct management of the identified factors associated with recurrent emergency admission, service and ICU hospitalization in COPD patients should be done both at home and in the hospital.

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