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Open Access Research article

Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study

Ketty Langlet12*, Thierry Van Der Linden1, Claire Launois3, Caroline Fourdin1, Philippe Cabaret1, Nadia Kerkeni1, Coralie Barbe2, François Lebargy2 and Gaetan Deslée3

Author Affiliations

1 Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France

2 Unité d’Aide Méthodologique, Pôle Recherche et Innovations, Hôpital Robert Debré, CHU de Reims, France

3 Service de Pneumologie, INSERM UMRS 903, Hôpital Maison Blanche, CHU de Reims, France

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BMC Pulmonary Medicine 2012, 12:66  doi:10.1186/1471-2466-12-66

Published: 18 October 2012

Abstract

Background

Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients.

Methods

We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality.

Results

The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01).

Conclusion

Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

Keywords:
Chronic obstructive pulmonary disease; Acute respiratory failure; Mechanical ventilation weaning; Mortality; Activities of Daily Living score