Objective  To explore the relationship between the use of proton pump inhibitors (PPIs) and the short-term and long-term prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods  Clinical data of AECOPD patients admitted to the intensive care unit (ICU) from January 2008 to December 2019 were extracted from the MIMIC-Ⅳ database. Patients were divided into PPIs group and non PPIs group based on whether PPIs were used during ICU treatment. Compare the general conditions of two groups of patients and plot survival curves using Kaplan-Meier method to compare the differences in survival rates between the two groups at 28 d and 90  d, respectively. Cox proportional hazards regression was used to analyze the association between PPIs usage and 28 d and 90 d mortality risk in two groups of patients.

Results  A total of 447 patients were included, including 358 in the PPIs group and 89 in the non PPIs group. The 28 d mortality rate and 90 d mortality rate of the PPIs group were 15.64% and 23.46%, respectively, which were lower than those of the non PPIs group (31.46% and 40.45%, respectively) (P<0.05). The Kaplan-Meier curve analysis showed that the 28 d and 90  d survival rates of the PPIs group were higher than those in the non PPIs group (P<0.001). The Cox proportional hazards regression analysis showed that after adjusting for all included variables,  the hazard ratio (HR) for 28 d and 90 d mortality in the PPIs group were 0.58 (95%CI 0.35 to 0.94, P=0.030), 0.63 (95%CI 0.41 to 0.96, P=0.022), respectively, compared to the non PPIs group.

Conclusion  In AECOPD patients, the use of PPIs may be reduce the 28  d and 90 d mortality risks.

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