Does admission from different sources have any influence on intensive care unit outcome in COPD patients?

Influence of admission source and admission source related factors on intensive care unit (ICU) outcome have not known much in patients with chronic obstructive pulmonary disease (COPD). The aim of the study was to investigate if admission source and related factors have any impact on ICU outcome in patients with COPD. A retrospective observational cohort study. Demographics of the patients, severity of admission disease and airflow limitation, comorbidity, source of admission [pulmonary ward (PW), emergency department (ED)], noninvasive mechanical ventilation (NIMV) therapies in the pre-and post-intubation period, and blood gases were recorded. T-test, chi-square test and logistic regression analysis were used for statistical analysis. One hundred and four patients were included in the study. Fifty two of them were admitted from PW and 52 from ED. There were no significant difference between age, gender, comorbidity, severity of airflow limitation and admission Acute Physiology Assessment and Chronic Health Evaluation (APACHE)-II scores among the patients admitted from PW and ED. While the patients admitted from ED were more hypoxemic, admitted with community acquired pneumonia more frequently, the patients admitted from PW, received NIMV trial in pre-intubation and post-extubation period more frequently (p<0.001) and had higher HCO-(3) levels. There was no significant difference in the ICU survival across the groups. Among these potential risk factors higher APACHE-II scores and duration of mechanical ventilation were independent risk factors for the mortality. These results suggest that while some of the admission characteristics were significantly different, admission from ED or PW did not have negative influence on ICU course and outcome in patients with COPD.