Frequency and factors leading to prolonged hospital stay and in-hospital mortality in patients admitted with acute exacerbation of chronic obstructive pulmonary disease

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major cause of morbidity and mortality. This study aimed to determine the frequency and predictors of prolonged hospital stays and in-hospital mortality in patients admitted with AECOPD. A cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan, from June to December 2024. A total of 150 patients admitted with AECOPD were enrolled. A prolonged stay was defined as >7 days. Data on demographics, clinical parameters, and outcomes were collected. Multivariable logistic regression was used to identify independent predictors. The mean age of participants was 72.5±10.4 years, with 63.3% being male. Prolonged hospital stay occurred in 25.3% of patients, and in-hospital mortality was 10.0%. Pseudomonas aeruginosa infection [adjusted odds ratio (aOR) 11.46, 95% confidence interval (CI): 2.49-52.70; p=0.002] was an independent predictor of prolonged stay. Vasopressor use was the independent predictor of in-hospital mortality (aOR 40.35, 95% CI: 4.49-362.79; p=0.001). In conclusion, Pseudomonas aeruginosa infection is significantly associated with prolonged hospitalization in AECOPD, while the need for vasopressors is strongly associated with mortality. Early identification of these factors can help in risk stratification and improve patient outcomes.