Outcome Predictors of Acute Exacerbations of Chronic Obstructive Pulmonary Disease at a Tertiary Healthcare Facility

Abstract Introduction: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) refer to episodes characterised by a deterioration of symptoms, which can lead to significant disease advancement, increased hospital admissions and higher mortality rates. Although detailed clinical assessments and biochemical markers can enhance early risk stratification, they are often underused in standard tertiary care environments. Materials and Methods: This cross-sectional study involved 100 patients admitted to a tertiary care facility due to AECOPD over 18 months. Data on demographics, clinical information, electrocardiogram results and biochemical metrics – including N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and eosinophil count – were collected and analysed. Outcomes were defined as either recovery or in-hospital mortality. Results: The average age of participants was 61.6 years (±13.3), with 57% of them being male. There was a notable connection between elevated NT-proBNP levels and a much higher mortality rate, observed at 55% compared to just 6.2%. Similar findings were noted with eosinophilia, where mortality rates were 53.8% versus 10.3%, and for P-pulmonale, which had rates of 52.9% compared to 8.4%. All these differences were statistically significant ( P < 0.001). In addition, the presence of hypertension and diabetes as comorbidities also significantly impacted mortality rates. While CRP and NLR showed moderate correlations with outcomes, these were not found to be statistically significant. Conclusion: The findings indicate that clinical severity, coexisting cardiovascular issues and specific biochemical markers can serve as independent predictors of mortality in patients with AECOPD. A thorough evaluation of these factors can enhance triage and management in tertiary care facilities.