Assessment of Initial Oxygenation Levels of Chronic Obstructive Pulmonary Disease (COPD) and Their Impact on Basis and Vital Tools: Retrospective Cohort Study From India.

Introduction Chronic obstructive pulmonary disease (COPD) is a significant contributor to global morbidity and mortality. Despite well-established management protocols, treatment remains suboptimal due to high costs and mortality rates. This study aims to compare the impact of initial oxygenation status, Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF), and National Early Warning Score 2 (NEWS2) scores on management outcomes in COPD patients. Methods In this retrospective study, we analyzed 100 consecutive patients admitted for COPD exacerbation. Patients were categorized into four groups based on admission oxygen saturation (SpO2): Group A (≤87%), Group B (88-92%), Group C (93-96%), and Group D (97-100%). Data collected included oxygen saturation, chest X-rays, laboratory findings, DECAF, and NEWS2 scores. Results The mean age of the cohort was 68.54 ± 10.95 years. Groups A and B (SpO2 ≤ 93-96%) had significantly higher rates of hypercapnia (50%), non-invasive ventilation use (63%), and prolonged hospital stays (15%) compared to Groups C and D (p < 0.05). A strong correlation was found between initial SpO2 and both DECAF (p = 0.04) and NEWS2 (p = 0.001) scores. DECAF correlated with arterial oxygen (pO2) and carbon dioxide (pCO2) levels, while NEWS2 was linked with pCO2, albumin, and white blood cell (WBC) counts (p < 0.05). Both DECAF and NEWS2 predicted longer hospital stays (p < 0.05). Conclusion An initial SpO2 ≤ 93-96% was an independent predictor of higher hypercapnia rates, extended hospitalization, and increased use of non-invasive ventilation. This emphasizes the importance of initial oxygenation status in the clinical assessment of COPD patients.