Patients with chronic obstructive pulmonary disease (COPD) are prone to acute exacerbations, which may result in acute respiratory failure. The type of respiratory failure impacts the prognosis.¹

A team of researchers from South Korea retrospectively reviewed medical records of 435 COPD patients who had been hospitalized between 2016 and August 2021 for to determine the 1-year mortality and readmission risk for acute exacerbations of COPD according to the type of respiratory failure. A total of 165 patients were categorized as type 1 hypoxemic acute respiratory failure, 100 as type 2 hypercapnic acute respiratory failure, while 170 patients did not have acute respiratory failure.

Patients in acute respiratory failure had higher frequency of use of high-flow nasal cannula, non-invasive ventilation and steroids. They were more likely to require intensive care. Mortality during hospitalization was higher among those with acute respiratory failure.

Patients with type 2 acute respiratory failure had advanced stage (GOLD) of COPD, which necessitated greater use of non-invasive ventilation, intubation and intensive care unit admission. Compared to patients without respiratory failure, those with type 1 acute respiratory failure were 3-times more likely to die within one year with a hazard ratio (HR) of 3.02. The risk of re-hospitalization within one year after discharge also increased 2-folds with HR of 2.05.

This study shows that acute respiratory failure patients with acute exacerbations of COPD had more negative outcomes compared to those without respiratory failure. Mortality at one year and rehospitalization rate was higher among those with type 1 respiratory failure.

Reference

1. Lee JK, et al. An analysis of the prognosis of chronic obstructive pulmonary disease patients with acute exacerbations based on types of acute respiratory failure. Am J Respir Crit Care Med. 2023;207:A3317. https://doi.org/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A3317.