Kumar and Choubey identified risk factors associated with mortality during an acute exacerbation of COPD. These can help to identify a patient who may benefit from more aggressive management. The authors are Dr Ram Lohio Institute of Medical Sciences in Lucknow and MGM Medical College in Indow, India.
Patient selection: acute exacerbation of COPD
Outcome: in-hospital mortality
Predictors of mortality from multivariate analysis:
The retention of carbon dioxide is a significant problem in COPD. The kidney attempts to compensate with metabolic alkalosis. When the kidney is not able to keep up there is a fall in the pH.
The mean blood glucose in non-survivors was 232 mg/dL, suggesting diabetes with acute phase glucose intolerance.
Altogether there are signs of multi-organ dysfunction.
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