Evaluating uric acid and electrolytes as predictors of acute exacerbation and disease severity in COPD

Abstract

Background: The third most common cause of mortality globally, chronic obstructive pulmonary disease (COPD) has a substantial impact on global health. Chronic airflow restriction and recurrent acute exacerbations are its hallmarks, and they raise morbidity, mortality, and medical expenses. Patients are vulnerable to electrolyte imbalances during acute exacerbations, which are frequently brought on by conditions including uremia, metabolic problems, respiratory acidosis, and hypoxemia. The World Health Organization estimates that 65 million people worldwide suffer from COPD, which causes 5% of all fatalities. Pulmonary hypertension and obstructive sleep apnoea are two respiratory disorders that have been linked to uric acid (UA), the final product of purine biosynthesis. UA is believed to engage in intricate inflammatory and metabolic processes that may be impacted by dietary and metabolic state, while its exact significance in the pathogenesis of COPD is yet unknown. Objective: This study aimed to evaluate whether serum uric acid and electrolyte levels can serve as predictive biomarkers for mortality in patients hospitalized with acute exacerbations of COPD (AECOPD). Methods: Data from 172 patients who were already receiving care at the respiratory care center (RCC) and chest unit at Al-Imamain Al-Kadhimain Medical City and Hospital of Baghdad City were gathered for this observational prospective study.  Results: Patients with hyperuricemia had a significantly higher risk of mortality than those with normal serum uric acid levels (HR = 2.29; 95% CI: 1.71–3.07; p < 0.0001). ROC curve analysis demonstrated that serum uric acid had strong predictive performance for adverse clinical outcomes in patients with AECOPD. Electrolyte abnormalities, particularly alterations in sodium, chloride, and potassium levels, were also associated with adverse outcomes. Conclusion: Hyperuricemia is a strong predictor of mortality in patients with AECOPD, while electrolyte disturbances may provide additional prognostic information. These findings support routine metabolic and electrolyte monitoring in patients hospitalized with AECOPD and provide a basis for further investigation of nutritional and metabolic approaches to COPD management. Novelty of the Study։ This study uniquely integrates serum uric acid and electrolyte biomarkers to predict mortality in AECOPD, highlighting their combined prognostic value and supporting their role within the Functional Food Center (FFC) 17-step framework. It provides new viewpoints on their function in pathophysiology and prognosis. Keywords: COPD, acute exacerbation of COPD, uric acid, serum electrolytes, mortality prediction.