D-dimer/Fibrinogen ratio and recurrent exacerbations might have a potential impact to predict 90-day mortality in patients with COPD exacerbation

BACKGROUND: According to the World Health Organisation reports (WHO), COPD is the third leading cause of overall in the World by 2020. AIM: We aimed to determine the prognostic predictors of 90-day mortality after an initial exacerbation in patients with acute exacerbation of COPD (AECOPD). RESULTS: Increased Charlson Comorbidity Score(CCS) (HR:1.47; p<0.05), readmission after initial exacerbation (HR:1.47; p<0.05) were predictive risk factors for 30-day mortality in multivariable regression model. The 90-day mortality rate was %11.8. Hypertension, increased median age, nutrition risk score (NRS), CCS, CAT score, and mMRC 4th level were possible risk factors for 90-day mortality. There was a significant difference in the mortality of patients with D-dimer/Fibrinogen ratios>0.11 and ≤0.11 (HR:2.47; p<0.05). Recurrent exacerbations after discharge were predictive risk factors for 90-day mortality in the multivariable regression model (HR:2.25; p<0.001) with the increased mortality risk 4.73 times (HR:4.73; p=0.002). Furthermore, a 1-unit increment of acute exacerbation increased the mortality risk 3.39 times (HR:3.39; p<0.001). CONCLUSION: Our study showed that D-dimer/Fibrinogen ratio but not D-dimer and recurrent exacerbations after discharge might have a critical impact on 90-day mortality.