• Wei Long and Miao-rong Xie.
• Beijing Friendship Hospital, Beijing 100050, China.
• Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 Jun 1;18(6):373-5.

ObjectiveTo investigate the feasibility of estimating risk of prognosis and hospital mortality in elderly patients (> or =60 years old) with chronic obstructive pulmonary disease (COPD) under the treatment of mechanical ventilation by using acute physiology and chronic health evaluation III (APACHE III).MethodsFifty elderly patients with COPD treated with mechanical ventilation were analyzed retrospectively. A risk estimation equation for hospital mortality was first developed by using APACHE III in evaluating 40 randomly-selected patients before mechanical ventilation. Changes in APACHE III on the 1 st, 3 rd and 7 th day for each patient after intubation were recorded and analyzed.ResultsThe risk estimate equation for hospital mortality was developed as p=Apa(gamma)/(D(gamma)(50)+Apa(gamma)), D(50)=73.4, gamma=8 with 80% prediction accuracy. A statistical significant cutoff was developed by dynamically recording acute physiology scores after intubation, and a decrease of 32.8% or more (compared with APACHE III before intubation) of APACHE III on the 3 rd day predicted survival of the patient.ConclusionAPACHE III score and its dynamic change could be an ideal tool to predict risk for hospital mortality in elderly patients with COPD on mechanical ventilation.

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