Chest X-ray: Is it still important in determining mortality in patients hospitalized due to chronic obstructive pulmonary diseases exacerbation in intensive care unit?

OBJECTIVE: The present research aims to evaluate the effects of chest X-rays on mortality among patients who were hospitalized due to the exacerbation of chronic obstructive pulmonary disease (COPD) in intensive care unit (ICU) of a secondary care hospital. MATERIALS AND METHODS: Sixty-three patients (39 males, 60.9%), who were hospitalized in ICU due to COPD exacerbation between December 1, 2011, and December 31, 2012, were retrospectively reviewed in this study. Data, including demographics, smoking history, arterial blood gas measurements, posterior-anterior lung radiography (PALR) findings and mortality, were collected from the medical records. RESULTS: The mean age of the patients was 70.5 years (standard deviation [SD]: 13.3, range 44–88 years). Of all the cases, 42 (85.7%) had at least one comorbidity. The most common comorbidities were hypertension (34, 53.9%) and heart failure (19, 30.2%). Mean duration of hospital stay was 8 days (SD: 5.7, range: 2–26). Mechanical ventilation support was required in 17 (27%) cases. In total, seven female and four male patients died during hospitalization (17.7%). PALR indicated emphysema in 60.3%, infiltration in 54%, bronchiectasis in 31.7%, and unilateral or bilateral pleural effusion in 27% of the cases. Infiltration and pleural effusion in PALR were more common among the patients who died (died/alived 10/11 vs. 24/52, P = 0.008 and 6/11 vs. 11/52, P = 0.026, respectively). The multivariate model for mortality showed that only age (odds ratio 0.821, CI: 0.687–0.948, P = 0.044) was independently related to mortality. CONCLUSION: As a basic imaging method, PALR still remains as an important diagnostic tool for COPD patients hospitalized in ICU, and it may contribute to the prediction of mortality