Factors associated with in-hospital mortality in patients with chronic obstructive pulmonary disease hospitalized to the intensive care unit due to septic shock

Aim: This study aimed to evaluate in-hospital mortality-related factors in patients with chronic obstructive pulmonary disease (COPD) who were admitted to the intensive care unit (ICU) due to septic shock. Material and Methods: This retrospective study included 62 COPD patients diagnosed with septic shock in a tertiary ICU. The Sepsis-3 criteria were used to establish the diagnosis of sepsis shock. Demographic and clinical data, including comorbid conditions, laboratory parameters, inflammatory markers, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, Sequential Organ Failure Assessment (SOFA) scores, and clinical outcomes were collected from electronic medical records. The modified Charlson Comorbidity Index (mCCI) calculation was based on the available comorbid conditions collected in the prehospital setting. Results: The mean age of the study population was 70.6 ± 11.0 years, and 67.7% were male. Higher mCCI scores [Hazard ratio (HR): 1.23, p = 0.002], along with elevated APACHE II (HR: 1.15, p < 0.001) and SOFA scores (HR: 1.35, p < 0.001), were independent predictors of in-hospital mortality. Among laboratory parameters, higher procalcitonin (HR: 1.04, p < 0.001), and C-reactive protein (HR: 1.03, p< 0.001) were associated with mortality in univariate analysis but did not remain significant in multivariate regression. The optimal mCCI cut-off for predicting mortality was ≥7, yielding a sensitivity of 72.5% and specificity of 94.7%. Conclusion: The mCCI, along with APACHE II and SOFA scores, serves as a significant independent predictor of mortality in COPD patients with septic shock. The mCCI may be a useful tool for risk stratification in this high-risk population.