Kronik Obstrüktif Akciğer Hastalığının Akut Alevlenmesinde Ürik Asit ve Ürik Asitin Kreatinine Oranı Mortalitenin Öngörücüleri midir?

Abstract

Aim: In the clinical course of Chronic Obstructive Pulmonary Disease (COPD), exacerbations that are defined as worsening of respiratory symptoms (dyspnoea, cough, sputum production) may occur, which causes poor prognosis and require additional treatments. Cost-effective mortality predictors are valuable for the treatment management of COPD. We aimed to investigate whether serum uric acid (UA) and serum uric acid to creatinine ratio (UCR) are predictors of mortality and hypoxemia in patients with acute exacerbations of COPD (AECOPD). Material and Methods: 105 patients with AECOPD who were hospitalized in a reference chest hospital between January 2014 and December 2018 were evaluated retrospectively in this cross-sectional study. The associations between UA and UCR and long-term mortality, hypoxemia, comorbidity, FEV1 value, and Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) stage were analyzed. Results: In the present study including 105 patients with AECOPD (97 males, mean age of 65±9 years), a significant correlation was found between hyperuricemia and mortality (95% CI:1.15-10.72, p=0.027; 95% CI:1.16-4.12, p=0.016, respectively), while no correlation was found between UCR and mortality (p=0.051, p=0.053, respectively). Low UA level was associated with hypoxemia significantly (p=0.022), but no association was observed between UCR and hypoxemia (p=0.094). Conclusion: It appears that UA is more important for predicting long-term mortality in patients with AECOPD than UCR. We suggest that UA can be used as a biomarker of long-term mortality for the identification of high-risk COPD patients that require frequent clinical follow-up and intense treatment management.