Predictors of hospitalization in patients presenting to emergency department with an acute exacerbation of COPD – a single-center study in Turkey

Abstract

Introduction and aim. In this study, we evaluated parameters that might be associated with hospitalization in patients admitted to the emergency department (ED) with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material and methods. Patients with COPD who presented to ED due to AECOPD between January 1, 2020 and December 31, 2021 were included in the study. Patient data were obtained from the hospital database. Univariable and multivariable logistic regression methods were used to identify the relationship between hospitalization and clinical parameters. Results. The study included 237 patients divided into two groups: inpatients (n=124) and outpatients (n=113). We found significant differences between the two groups in terms of temperature, oxygen saturation, respiratory rate, C-reactive protein, white blood cell count, procalcitonin, albumin, arterial blood pH, pCO 2 , and non-invasive mechanical ventilation (NIMV) requirement. Multivariable logistic regression analysis showed that body temperature [odds ratio (OR):1.62;95% confidence interval (CI):1.21–4.91; p<0.001], oxygen saturation (OR:0.73, 95% CI:0.39-0.94, p<0.001), respiratory rate (OR:1.96; 95% CI: 1.07–6.14; p<0.001), albumin (OR:0.71; 95% CI:0.41–0.93; p=0.042), procalcitonin (OR:2.93; 95% CI:1.22–4.84; p<0.001), arterial blood pH (OR:0.78; 95% CI:0.29-0.91; p=0.038), pCO 2 (OR:2.45; 95% CI:1.24–4.65; p<0.001), and NIMV requirement (OR:2.31; 95% CI:1.41–5.13; p<0.001) were the independent predictors of hospitalization. Conclusion. Our findings may help identify patients who will require hospitalization at an early stage.