Hematological Parameters Predicting Mortality in Patients with COPD Admitted to ICUs

Background: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing in Saudi Arabia, yet there is a lack of studies on the usefulness of routine hematological parameters in predicting mortality. Objective: To determine hematological parameters that can predict mortality in patients with COPD exacerbation admitted to intensive care units. Materials and Methods: This multicenter retrospective study included patients with COPD admitted at intensive care units of Ministry of National Guard Health Affairs hospitals in Saudi Arabia between 2016 to 2021. Hematological parameters were used to predict mortality. ROC curve analysis was used to establish the threshold value of variables linked to risk of mortality and optimal cut-off points, and its sensitivity and specificity were determined. Results: The study included 323 patients with COPD, of which 61 were females and the mean age was 72.7 (±12.7) years. The median length of hospital stay was 14 days (range: 6-26 days), and the overall mortality rate was 37.2. After adjusting for gender and length of hospital stay in the multivariate analysis, independent predictors of mortality were age (OR: 1.029, 95 CI: 1.008-1.051; P = 0.007) and low mean corpuscular hemoglobin concentration (MCHC) (OR: 0.985, 95 CI: 0.970-1.000; P = 0.047). The ROC curve analysis revealed a cut-off value of 320.5 g/L for MCHC, with an AUC of 0.576. Conclusion: This study found that in patients with COPD exacerbation admitted to ICU, older age likely increases the risk of mortality, whereas low MCHC likely decreases the risk of mortality. Further large-scale studies are required to validate these findings. Keywords: Age, chronic obstructive pulmonary disease, exacerbation, hematological parameters, intensive care unit, mean corpuscular hemoglobin concentration, mortality