Association Between Comorbid Chronic Obstructive Pulmonary Disease and Prognosis of Patients Admitted to the Intensive Care Unit for Non-COPD Reasons: A Retrospective Cohort Study.

Background and Aim: Chronic obstructive pulmonary disease (COPD) is a rather common comorbid condition among patients admitted to the intensive care unit (ICU), while evidence of how this comorbidity affects prognosis is limited. This study aimed to investigate the associations between COPD comorbidity and prognoses of patients who were admitted to the ICU for non-COPD reasons, and to examine whether the associations varied between different types of ICU. Methods: A retrospective cohort study was performed using data extracted from a freely accessible critical care database (MIMIC-III). Adult (≥18 years) patients of first ICU admission in the database were enrolled as study participants but those with a primary diagnosis of COPD were excluded. The primary endpoint was 28-day mortality after ICU admission and multivariable Cox regression analyses were employed to assess the associations between COPD comorbidity and the study endpoints. Different adjusting models including a propensity score were used to adjust potential confounders. Results: A total of 29,499 patients were enrolled finally, among which 3,332 patients (11.30%) were comorbid with COPD. A higher 28-day mortality was observed among patients with COPD than those without COPD (13.90% versus 8.07%, Conclusion: Comorbid COPD increased the risk of 28-day mortality among patients admitted to the ICU for non-COPD reasons, especially for those admitted to the cardiac surgery recovery unit.