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Review paper
Published: 01.12.2022. Biochemistry
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https://doi.org/10.17392/1514-22

Parameters in predicting the risk of a prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease: a single-centre experience

By
Aida Mujaković Orcid logo ,
Aida Mujaković
Contact Aida Mujaković

Department of Pulmonology, General Hospital “Prim. dr. Abdulah Nakaš“, Sarajevo, Bosnia and Herzegovina

Department of Pathophysiology, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

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Belma Paralija ,
Belma Paralija

Clinic for Pulmonary Diseases and Tuberculosis “Podhrastovi”, University of Sarajevo Clinical Centre, Sarajevo, Bosnia and Herzegovina

Department of Internal Medicine, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Besim Prnjavorac ,
Besim Prnjavorac

Department of Pathophysiology, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

Department of Pulmonology, General Hospital Tešanj, Tešanj, Bosnia and Herzegovina

Department of Pathophysiology, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

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Orhan Lepara ,
Orhan Lepara

Department of Physiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Almir Fajkić ,
Almir Fajkić

Department of Pathophysiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Edin Begić ,
Edin Begić

Department of Cardiology, General Hospital “Prim.dr Abdulah Nakaš“, Sarajevo, Bosnia and Herzegovina

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Avdo Kurtović ,
Avdo Kurtović

Primary Healthcare Centre Gračanica, Gračanica, Bosnia and Herzegovina

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Midhat Čizmić ,
Midhat Čizmić

Department of Radiology, General Hospital “Prim. dr Abdulah Nakaš“, Sarajevo, Bosnia and Herzegovina

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Mirad Odobašić
Mirad Odobašić

Private Healthcare Institution „Poliklinika dr. Odobašić“, Sarajevo, Bosnia and Herzegovina

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Abstract

Aim
To identify clinical and laboratory parameters on admission and/or during a hospital stay that would predict prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Methods
A retrospective cross-sectional study was conducted at the Clinic for Pulmonary Diseases and Tuberculosis, Clinical Centre University of Sarajevo for the period 2019-2021 accounting patients admitted due to AECOPD. The need for hospitalization was evaluated according to the current GOLD criteria and certain clinical parameters. Spirometry testing and laboratory analysis were performed for all patients on the day of admission and on the 10th day of hospital stay. Linear regression was used to show the relationship between multiple independent predictor variables
and LOS.
Results
A total of 50 patients were evaluated during their hospital stay due to AECOPD. Median of LOS was 22.02±1.06, with 90%
hospital survival rate. Due to AECOPD the median of LOS in the intensive care unit (ICU) was 4±0.68 days with pH<7.35 in 34% of hospitalized patients. According to spirometry classification on the day of admission, 56% of patients were assigned to group 3 and 16% to group 4 with significant improvement identified on spirometry findings on discharge. Platelets on the day of admission were the only statistically significant positive predictors of the length of hospital stay.
Conclusion
Identifying chronic obstructive pulmonary disease patients at risk of frequent exacerbations and appropriate disease
management could reduce the disease burden.

Keywords:

chronic obstructive pulmonary disease,
hospitalization,
therapeutics

References

1.
Gender.
2.
Smoking status (non-smoker/smoker/passive smoker/ ex-smoker.
3.
Number of AECOPD (without exacerbation/in last 3 months/in last 6 months/in last 12 months.
4.
Upper respiratory tract infection (yes/no) (%.
5.
Sputum.
6.
Sputum. p. 8–14.
7.
Chest pain (yes/no) (%).
8.
Spirometry on admission.
9.
Spirometry on discharge.
10.
34/66 ICU stay (days) 4±0.68 ESR on admission 45.34±5.55 CRP on admission (mg ⁄L).
11.
Erythrocytes on admission. p. 12.
12.
Haemoglobin on admission.
13.
Haematocrit on admission.
14.
Platelets on admission. p. 295–311.
15.
Leucocytes on admission.
16.
Neutrophils.
17.
Lymphocytes. p. 10–1.
18.
Eosinophils.
19.
ESR on the 10 th day of hospital stay 25.98±4.07 CRP on the 10 th day (mg ⁄L).
20.
Erythrocytes on the 10 th day.
21.
Platelets on the 10 th day.
22.
Leukocytes on the 10 th day (x109⁄L) 9.
23.
Eosinophiles on the 10 th day (%) 1.46±0.23 NLR on the 10 th day of hospital stay 3.09±0. p. 78.
24.
GOLD-Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2022.
25.
Halpin D, Criner G, Papi A, Singh D, Anzueto A, Martinez F, et al. Global Initiative for the diagnosis, management, and prevention of chronic obstructive lung disease. The 2020 GOLD Science Committee Report on CO-VID-19 and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2021. p. 24–36.
26.
Donaldson G, Law M, Kowlessar B, Singh R, Brill S, Allinson J, et al. Impact of prolonged exacerbation recovery in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015. p. 943–50.
27.
Singanayagam A, Schembri S, Chalmers J. Predictors of mortality in hospitalized adults with acute exacerbation of chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2013. p. 81–9.
28.
Donaldson G, Müllerova H, Locantore N, Hurst J, Calverley P, Vestbo J, et al. Factors associated with change in exacerbation frequency in COPD. Respir Res. 2013. p. 79.
29.
Van Bragt J, Vijverberg S, Weersink E, Richards L, Neerincx A, Sterk P, et al. Blood biomarkers in chronic airways diseases and their role in diagnosis and management. Expert Rev Respir Med. 2018. p. 361–74.
30.
Natori H, Kawayama T, Suetomo M, Kinoshita T, Matsuoka M, Matsunaga K, et al. Evaluation of the modified Medical Research Council Dyspnea scale for predicting hospitalization and exacerbation in Japanese patients with chronic obstructive pulmonary disease. Intern Med. 2016. p. 15–24.
31.
George P, Stone R, Buckingham R, Pursey N, Lowe D, Roberts C. Changes in NHS organization of care and management of hospital admissions with COPD exacerbations between the national COPD audits of. QJM. 2003. p. 859–66.
32.
Busby J, Purdy S, Hollingworth W. A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions. BMC Health Serv Res. 2015. p. 324.
33.
Ruparel M, López-Campos J, Castro-Acosta A, Hartl S, Pozo-Rodriguez F, Roberts C. Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit. ERJ Open Res. 2016. p. 34–2015.
34.
García-Sanz M, González-Barcala F, Gómez C, García-Couceiro J, Alonso-Acuña N, Carreira S, et al. Prolonged stay predictors in patients admitted with chronic obstructive pulmonary disease acute exacerbation. Lung India. 2018. p. 316–20.
35.
Crisafulli E, Ielpo A, Barbeta E, Ceccato A, Huerta A, Gabarrús A, et al. Clinical variables predicting the risk of a hospital stay for longer than 7 days in patients with severe acute exacerbations of chronic obstructive pulmonary disease: a prospective study. Respir Res. 2018. p. 261.
36.
Wang H, Yang T, Yu X, Chen Z, Ran Y, Wang J, et al. Risk factors for length of hospital stay in acute exacerbation chronic obstructive pulmonary disease: a multicenter cross-sectional study. Int J Gen Med. 2022. p. 3447–58.
37.
Gómez-Rosero J, Cáceres-Galvis C, Ascuntar J, Atencia C, Vallejo C, Jaimes F. Biomarkers as a prognostic factor in COPD exacerbation: a cohort study. COPD. 2021. p. 325–32.
38.
Inabnit L, Blanchette C, Ruban C. Comorbidities and length of stay in chronic obstructive pulmonary disease patients. COPD. 2018. p. 355–60.
39.
Wilkinson T, Donaldson G, Hurst J, Seemungal T, Wedzicha J. Early therapy improves outcomes of exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004. p. 1298–303.
40.
Miravitlles M, Kruesmann F, Haverstock D, Perroncel R, Choudhri S, Arvis P. Sputum colour and bacteria in chronic bronchitis exacerbations:a pooled analysis. Eur Respir J. 2012. p. 1354–60.
41.
Soler N, Esperatti M, Ewig S, Huerta A, Agustí C, Torres A. Sputum purulence-guided antibiotic use in hospitalised patients with exacerbations of COPD. Eur Respir J. 2012. p. 1344–53.
42.
Steer J, Norman E, Afolabi O, Gibson G. Bourke SC. Dyspnea severity and pneumonia as predictors of in-hospital mortality and early readmission in acute exacerbations of COPD. Thorax. 2012. p. 117–21.
43.
Wong A, Gan W, Burns J, Sin D, Van Eeden S. Acute exacerbation of chronic obstructive pulmonary disease: influence of social factors in determining length of hospital stay and readmission rates. Can Respir J. 2008. p. 361–4.
44.
Mantero M, Rogliani P, Pasquale D, Polverino M, Crisafulli E, Guerrero E, et al. Acute exacerbations of COPD: risk factors for failure and relapse. Int J Chron Obstruct Pulmon Dis. 2017. p. 2687–93.

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