Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with acute respiratory failure (ARF) carries a notable economic burden, both for patients and societies. Climate change can trigger can AECOPD. The aim of the study was to determine the association between weather and emergency department visits (EDVs) for AECOPD with ARF.

Methods: This was a prospective observational study. Data from the electronic medical record and data from the central weather bureau were evaluated over an 8-year period. Lowess-Regression analysis was performed to assess the relationship between the meteorological factors and EDVs for AECOPD with ARF.

Results: 1480 AECOPD patients with ARF were included (mean age: 68 ± 17 yrs; age >64 years: 83.4%; male: 81.5%; intubation: 18%). Compared to mean temperatures (23.6°C), probability of AECOPD with ARF increased significantly at temperatures above 35.8°C (p = 0.037) and below 18.2°C (p = 0.015). Regarding relative humidity, increased probability was above a threshold-value of 76% (p = 0.025). Increased probability was seen at atmospheric pressure above 1008 hPa (p = 0.026) and below 997 hPa (p = 0.035). Probability of AECOPD with ARF increased with sunshine below 70 hours (p = 0.012) and above 220 hours (p = 0.048).

Conclusions: There are associations between meteorological factors such as air pressure, humidity, sunshine, and temperature, and occurrence of EDVs for AECOPD with ARF. Particularly dangerous seem to be colder weather, extreme heat, high humidity, and short sunshine.