급성 발작으로 내원한 만성폐쇄성 폐질환 환자에서 사망의 예측 인자

Abstract

Chronic obstructive pulmonary disease(COPD) is one of the important caus-es of death in Korea, Having mortality rate of 11.4 per 100,000 in 1992. The mortality rate of acutely exacerbated COPD ranges from 6% to 40%. These discrepancies are probably due to differences in baseline patient's characteristics. This study aimed to verify the risk factors of mortality through examination of baseline clinical and laboratory parameters in acutely exacerbated COPD patients. Method: The 245 COPD with acute exacerbation patients were hospitalized in Yongdong Severance Hospital of Yonsei Medical College from January, 1985 to December, 1994. The patients' clinical and laboratory variables were analyzed retrospectively, including age, sex, body weight and height and were compared between two groups, death group(n=64) and survival group(n=181). Result: The mortality rate was 26.1%, 64 out of 245. The mean age of death group was 71.0±10.9, which was older than survival group, having no significance. The pulse rate(p<0.001), alveolar-arterial oxygen gradient(p<0.001) in death group were greater than survi-val group. The body mass index(p<0.001), serum albumin(p<0.001), serum sodium ion(p<0.001), serum chloride ion(p<0.001) were significant lesser than survival group. The vavia-bles with Odds Ratio(OR) were serum albumin ≤3.4g/dL(OR 5.65), pulse rate ≥92/min(OR 4.92), chloride ion ≤100mEq/L(OR 3.57), alveoar-arterial oxygen gradient ≥40.1mmHg(OR 3.38), and existence of inflammatory lung disease(OR 1.70).

Conclusion : Serum albumin ≤3.4g/dL(OR 5.65), pulse rate ≥92/min(OR 4.92), chloride ion ≤100mEq/L(OR 3.57), alveolar-arterial oxygen gradient ≥40.1mmHg(OR 3.38), existe-nce of inflammatory lung disease(OR 1.70) were predictive factors of death in acutely ex-acerbated COPD patients.