The rate of ward to intensive care transfer and its predictors among hospitalized COPD patients, a retrospective study in a local tertiary center in Saudi Arabia

Abdallah Y Naser; Mohammad Saleh Dairi; Hassan Alwafi; Deema Sami Ashoor; Sami Qadus; Abdulelah M Aldhahir; Abdullah A Alqarni; Wael Aly Elrefaey; Sultan Qanash; Waleed Hafiz; Jaber S Alqahtani; Rakan Ekram; Amjad Abuirmeileh; Anan S Jarab; Omaima Ibrahim Badr

doi:10.1186/s12890-023-02775-z

The rate of ward to intensive care transfer and its predictors among hospitalized COPD patients, a retrospective study in a local tertiary center in Saudi Arabia

BMC Pulm Med. 2023 Nov 22;23(1):464. doi: 10.1186/s12890-023-02775-z.

Authors

Abdallah Y Naser^#¹, Mohammad Saleh Dairi^#², Hassan Alwafi³, Deema Sami Ashoor², Sami Qadus⁴, Abdulelah M Aldhahir⁵, Abdullah A Alqarni⁶, Wael Aly Elrefaey⁷, Sultan Qanash⁸, Waleed Hafiz², Jaber S Alqahtani⁹, Rakan Ekram¹⁰, Amjad Abuirmeileh¹¹, Anan S Jarab^{12

13

14}, Omaima Ibrahim Badr^{7

15}

Affiliations

¹ Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan. abdallah.naser@iu.edu.jo.
² Pharmacology and Toxicology Department, Faculty of Medicine, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.
³ Pharmacology and Toxicology Department, Faculty of Medicine, Umm Al-Qura University, Makkah, 21955, Saudi Arabia. hhwafi@uqu.edu.sa.
⁴ Department of Pharmacy, Faculty of health sciences, American University of Madaba, Madaba, Jordan.
⁵ Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.
⁶ Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
⁷ Department of Pulmonary Medicine, Al Noor Specialist Hospital, Mecca, Saudi Arabia.
⁸ Department of Internal Medicine, National Guard Hospital, Jeddah, Saudi Arabia.
⁹ Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia.
¹⁰ School of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia.
¹¹ Faculty of Pharmacy, Middle East University, Amman, Jordan.
¹² College of Pharmacy, AL Ain University, P.O. Box 112612, Abu Dhabi, United Arab Emirates.
¹³ AAU Health and Biomedical Research Center, Al Ain University, P.O. Box 112612, Abu Dhabi, United Arab Emirates.
¹⁴ Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
¹⁵ Department of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.

^# Contributed equally.

Abstract

Objective: To investigate the prevalence of intensive care unit (ICU) admission and its predictors among hospitalized chronic obstructive pulmonary disease (COPD) patients.

Methods: An observational retrospective study was conducted. All patients with a confirmed diagnosis of COPD according to the GOLD guidelines between 28 and 2020 and 1 March 2023 at Al-Noor Specialist Hospital were included in this study. Patients were excluded if a preemptive diagnosis of COPD was made clinically without spirometry evidence of fixed airflow limitation. Descriptive results were presented as frequency (percentage) for categorical variables and mean (SD) for continuous variables and to estimate prevalence of ICU admission. Predictors of ICU admission among hospitalized COPD patients were determined using logistic regression analysis. A SPSS (Statistical Package for the Social Sciences) version 25 was used to perform all statistical analysis.

Results: A total of 705 patients with COPD were included in this study. The mean age was 65.4 (25.3) years. Around 12.4% of the hospitalized patients were admitted to the ICD. Logistic regression analysis identified that older age (OR; 1.92, (1.41-2.62)), smoking (OR; 1.60 (1.17-2.19)), and having specific comorbidities (Hypertension (OR; 1.98 (1.45-2.71)), Diabetes mellitus (OR; 1.42 (1.04-1.93)), GERD (OR; 2.81 (1.99-3.96)), Ischemic heart disease (OR; 3.22 (2.19-4.75)), Obstructive sleep apnea syndrome (OR; 2.14 (1.38-3.33)), stroke (OR; 4.51 (2.20-9.26))) were predictors of ICU admissions among patients with COPD.

Conclusions: Our study found that a step-up approach to inpatient COPD management requires admission to the ICU in 12.4%, for which age, smoking status, cardiovascular, and stroke were important predictors. Further clinical research is needed to provide a validated model that can be incorporated into clinical practice to monitor this patient population during their admission and identify at-risk individuals for early transfer to higher acuity settings and intensive care units.

Keywords: Admissions; COPD; Hospital; ICU; Saudi Arabia.

Publication types

Observational Study

MeSH terms

Aged
Critical Care / methods
Hospitals
Humans
Intensive Care Units
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / epidemiology
Pulmonary Disease, Chronic Obstructive* / therapy
Retrospective Studies
Saudi Arabia / epidemiology
Stroke*