Morbidity and mortality in geriatric patients with chronic obstructive pulmonary disease in an intensive care unit
Keywords:
exacerbated chronic obstructive pulmonary disease, chronic obstructive pulmonary disease in a geriatric patient, severe exacerbation of chronic obstructive pulmonary diseaseAbstract
Introduction: exacerbated chronic obstructive pulmonary disease is a frequent cause of admission to critical patients care units, with high mortality, which causes high costs to health systems.
Objective: to characterize morbidity and mortality due to exacerbated chronic obstructive pulmonary disease in geriatric patients in the Intensive Care Unit.
Methods: an observational, descriptive, retrospective study was carried out in the Intensive Care Unit of the Clinical Surgical University Hospital Comandante Faustino Pérez Hernandez in the period between January 2021 and January 2022. Demographic and clinical variables were used. The information was collected through a data collection form prepared by the authors, based on information obtained from medical records. Percentage analysis was used and the results were presented in tables.
Results: In both sexes, respiratory infections were the most frequent cause of exacerbation, representing 71.2%. The most frequently used respiratory support method required by the patient was assisted mechanical ventilation with 58%. The predominant cause of non-invasive ventilation failure was worsening respiratory acidemia, representing 34%. In the deceased patients, the male sex predominated with 66%, and the age group of 66 to 70 years old, with 29.8%. 71.2% of patients had respiratory infection as the cause of exacerbation upon admission; 66.9% of them died. Assisted mechanical ventilation was used in 90% of those who died. 65% of those who requested assisted mechanical ventilation required it for a period of more than 7 days; of them, 63% died.
Conclusions: The most used type of ventilatory support was assisted mechanical ventilation; the most frequent cause of non-invasive ventilation failure of was worsening respiratory acidemia. In the deceased patients, the male sex, the age group of 66 to 70 years old, respiratory infections as a cause of exacerbation, the use of mechanical ventilation and its use for 7 days or more predominated.
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2. Miranda Pedroso R, Martínez JR. La enfermedad pulmonar obstructiva crónica reagudizada en una unidad de cuidados intensivos. Medimay [Internet]. 2020 [citado 23/12/2021];27(3):277-87. Disponible en: http://www.medimay.sld.cu/index.php/rcmh/article/view/1715
3. Villacres Fernández FA, Gavilanes Torres AA, Cruz Villegas JA. Enfermedad Pulmonar Obstructiva Crónica (EPOC). RECIMUNDO. 2022;6(3):94-102. DOI: 10.26820/recimundo/6.(3).junio.2022.94-102.
4. González Díaz D, Cando Neira MA, Fernández García F, et al. Caracterización clínica, funcional e imagenológica de pacientes egresados por enfermedad pulmonar obstructiva crónica. Rev Inf Cient [Internet]. 2021 [citado 12/07/2022];100(1). Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/3214/4592
5. De Abajo Larriba AB, Díaz Rodríguez A, González-Gallego J, et al. Diagnóstico y tratamiento del hábito tabáquico en pacientes con enfermedad pulmonar obstructiva crónica: estudio ADEPOCLE. Nutr Hosp [Internet]. 2016 [citado 06/04/2024];33(4):954-61. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112016000400029&lng=es https://dx.doi.org/10.20960/nh.398
6. Cortes Telles A, Cureño Arroyo JA, Elizondo Ríos A, et al. Impacto de las exacerbaciones en la enfermedad pulmonar obstructiva crónica: Exacerbaciones en la EPOC. Respirar [Internet]. 2023 [citado 04/04/2024];15(2). Disponible en: https://respirar.alatorax.org/index.php/respirar/article/view/113
7. Montufar Andrade F, Díaz Santos GA, Matiz C, et al. Exacerbación aguda de EPOC en la época de COVID-19. Rev Colomb Neumol [Internet]. 2021 [citado 04/04/2024];32(1):47-5. Disponible en: https://revistas.asoneumocito.org/index.php/rcneumologia/article/view/510
8. López-Castro JH, Martínez-González C, Rego-Hernández JdJ, et al. Causas asociadas a mortalidad por epoc en el Hospital Clínico Quirúrgico Docente “Dr. Salvador Allende”. Rev Inf Cient [Internet]. 2022 [citado 05/04/2024];101(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-99332022000200003&lng=es
9. Betancourt-Reyes GL, Betancourt-Betancourt G. Predictores de éxito en el empleo de la ventilación mecánica no invasiva. Rev Ciencias Médicas [Internet]. 2023 [citado 04/04/2024];27:e5929. Disponible en: http://revcmpinar.sld.cu/index.php/publicaciones/article/view/5929
10. Yin p, Jiang CQ, Cheng KK, et al. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. Lancet [Internet]. 2007 [citado 04/04/2024];370(9589):751-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17765524/
11. Rodríguez-Concepción JP, Conde-Fernández BD, Valdés-Rodríguez MF, et al. Características clínicas de pacientes con exacerbación de la enfermedad pulmonar obstructiva crónica. Rev Cubana Med Milit [Internet]. 2022 [citado 05/04/2024];51(4). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2476
12. Mora-Madero AE, Briones-Dolberg SP, Santillan-Dolberg AL, et al. Beneficio de la ventilación mecánica no invasiva en insuficiencia respiratoria aguda hipercápnica en paciente con EPOC grave agudizada. Dom Cien [Internet]. 2022 [citado 05/04/2024];8(2):1547-64. Disponible en: https://dominiodelasciencias.com/ojs/index.php/es/article/view/2740
13. Navarro Rodríguez Z, Romero García LI, Guzmán Pérez N, et al. Escala de predicción del fracaso de la ventilación no invasiva en la enfermedad pulmonar obstructiva crónica agudizada [Internet]. La Habana: Convención Internacional de Salud “Cuba Salud 2022”; 2022 [citado 05/04/2024]. Disponible en: https://convencionsalud.sld.cu/index.php/convencionsalud22/2022/paper/download/564/203
14. Ralf E, Heine A, Obst A, et al. Acute COPD exacerbation treatment with noninvasive ventilation. Sci Rep. 2023;13(1). DOI: 10.1038/s41598-023-33871-z.
15. Rodríguez Pérez I, Sagaró del Campo NM, Zamora Matamoros L, et al. Factores pronósticos en la enfermedad pulmonar obstructiva crónica exacerbada. Rev Electrón Dr Zoilo E Mar Vidaurreta [Internet]. 2021 [citado 20/05/2023];46(2). Disponible en: http://revzoilomarinello.sld.cu/index.php/zmv/article/view/2643
16. García Gómez A, Ramírez Cruz N, Agüero Carbonell Y, et al. Caracterización de pacientes con enfermedad pulmonar obstructiva crónica en la unidad de cuidados intensivos. Rev Cubana Med Milit [Internet]. 2021 [citado 05/04/2024];50(4) Disponible en: http://revmedmilitar.sld.cu/index.php/mil/article/view/1407
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