Factors Associated with Acute Exacerbation among Patients with Chronic Obstructive Pulmonary Disease at Borabue Hospital, Maha Sarakham Province, 2025

Abstract

Abstract

            Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of mortality and significant healthcare expenditure.
This retrospective analytical study aimed to identify the factors associated with acute exacerbation among 358 patients diagnosed with COPD at Borabue Hospital, Maha Sarakham Province, in 2025. Data were retrieved from electronic medical records and analyzed using descriptive statistics and multiple logistic regression to determine the adjusted odds ratio (AOR) with a 95% confidence interval.

            The results showed that the incidence rate of acute exacerbation was 8.66%. Multivariate analysis revealed that factors significantly and independently associated with acute exacerbation (p < 0.05) included a history of missed medical appointments, which presented the highest risk
(AOR = 8.94; 95% CI: 2.95–27.08), followed by disease severity at GOLD groups C–D (AOR = 3.58; 95% CI: 1.39–9.21) and current smoking (AOR = 2.73;
95%CI: 1.18–6.32). Personal factors, such as sex, age, and alcohol consumption, showed no significant association with the exacerbation of the disease.
In conclusion, treatment adherence, smoking status, and disease severity are crucial predictors of acute exacerbation. Therefore, healthcare facilities should implement proactive monitoring systems, particularly for patients with poor follow-up records and those in high-risk categories (GOLD C-D), alongside intensive smoking cessation programs to reduce hospital readmission rates and enhance long-term disease management.

Keywords : Chronic Obstructive Pulmonary Disease (COPD), Acute Exacerbation, Retrospective Study, Treatment Adherence