Chronic Respiratory Disease最新文献

{"title":"Physiotherapy assessment of breathlessness and disordered patterns of breathing: Defining a consensus on terminology and assessment.","authors":"Lizzie Jf Grillo, Izzie Easton, Fiona M Schreuder, Adam Lewis, Chloe I Bloom, Nicholas S Hopkinson, Harriet Shannon, Anne-Marie Russell","doi":"10.1177/14799731251315483","DOIUrl":"10.1177/14799731251315483","url":null,"abstract":"<p><p><b>Introduction:</b> Abnormal breathing patterns unexplained by pathophysiology are typically referred to using terms including chronic breathlessness syndrome or complex breathlessness. Often patients with these conditions are referred to physiotherapy for an assessment of this breathlessness, where some are diagnosed with breathing pattern disorder (BrPD) or dysfunctional breathing (DB). The condition seen in physiotherapy occurs in at least 10% of the general population, increasing to 29-40% with coexisting conditions. Inconsistency in the nomenclature and physiotherapy assessment reduces recognition of the condition and hinders development in this area. <b>Aims of the study:</b> To establish expert physiotherapists' consensus on terminology to describe this condition and provide guidance for its physiotherapy assessment. <b>Participants and methods:</b> The opinions and experiences of ten respiratory physiotherapists, nine other clinicians (doctors, nurses, and speech and language therapists), and five patients diagnosed with BrPD were explored in focus groups or interviews regarding the terminology used and assessment experience. A second separate purposive sample of clinical expert physiotherapists (<i>n</i> = 11) took part in a nominal group technique (NGT) process to build consensus on the following questions: Question 1: What is your preferred term for this condition? Question 2: What are the most important assessment components to be included in all assessments? <b>Results:</b> One focus group (<i>n</i> = 10) and 14 interviews were completed. Framework analysis of the data from focus groups and interviews was undertaken and these results were shared with the participants in the nominal group. Consensus (71%) for the term breathing pattern disorder (BrPD) was achieved and an assessment guide was created. <b>Conclusion:</b> With improved consistency in its description and assessment, the adoption of breathing pattern disorder may help to further develop clinical and research priorities in this area within physiotherapy services.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251315483"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a clinical prediction model for falls in community-dwelling older adults with COPD: A preliminary analysis.","authors":"Khang T Nguyen, Cindy Ellerton, Joshua Wald, Natya Raghavan, Luciana G Macedo, Dina Brooks, Roger Goldstein, Marla K Beauchamp","doi":"10.1177/14799731251321494","DOIUrl":"10.1177/14799731251321494","url":null,"abstract":"<p><strong>Background: </strong>People with chronic obstructive pulmonary disease (COPD) are at a higher risk of falls. This preliminary study aims to externally validate a previously developed clinical prediction model for falls in community-dwelling older adults with COPD.</p><p><strong>Methods: </strong>This was a secondary analysis of a 12-month prospective cohort study. Older adults (≥60 years) with COPD, who reported a fall in the past year and/or had balance concerns, were tracked for 12-month future falls. Baseline predictors included 12-month history of ≥2 falls, total chronic conditions, and Timed Up and Go Dual-Task (TUG-DT) test scores. Model performance was assessed for discrimination (c-statistic), calibration (E:O, CITL, and calibration slope), and clinical value (decision curve analysis).</p><p><strong>Results: </strong>The study included 89 participants (average age 73 ± 9 years; 83 females; FEV₁%predicted = 47%). Of these, 35 (39%) reported ≥1 future fall, totaling 89 falls. The model demonstrated acceptable discrimination (c-statistic = 0.62, CI [0.51,0.72]), and calibration (E:O = 1, CITL = 0, and a calibration slope = 1). Decision curve analysis showed greater clinical value when using the prediction model compared to screening for fall history alone.</p><p><strong>Conclusions: </strong>A 12-month history of ≥2 falls, higher total chronic conditions, and worse TUG-DT test scores, predicts falls in community-dwelling older adults with COPD. Larger studies are needed before clinical application.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251321494"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time experience of an acute exacerbation of COPD: A qualitative exploration.","authors":"Bedor S Alkhathlan, Amy C Barradell, Neil J Greening, Theresa Harvey-Dunstan, Sally J Singh","doi":"10.1177/14799731251340407","DOIUrl":"10.1177/14799731251340407","url":null,"abstract":"<p><p><b>Introduction:</b> Many qualitative studies have explored patients' experiences of an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) retrospectively. To our knowledge, no study has conducted a real-time investigation of COPD exacerbation experience during hospitalisation.<b>Objective:</b> To establish an in-depth and comprehensive understanding of the whole COPD exacerbation experience and uncover any unrecognised burdens that might serve as barriers to engagement in discharge services post-AECOPD.<b>Methods:</b> Semi-structured interviews were conducted, and data were analysed using thematic analysis. The study included participants who were admitted to the hospital with a primary diagnosis of AECOPD.<b>Results:</b> Twelve participants were included in the study (Male, <i>n</i> = 9; Female, <i>n</i> = 3), with a mean ± SD age of 66 ± 8 years. Findings generated three overarching themes, and sub-themes: (I) Health deterioration phase (II) Implications of AECOPD and the associated hospitalisation, and (III) Recovery journey.<b>Conclusion:</b> The impact of breathlessness appears to extend across the COPD exacerbation journey and, for some, well beyond. Breathlessness both within and extending beyond the acute phase was associated with comorbid psychological distress. Interventions should consider appropriate phasing within the management process, focus on breathlessness and involve a behavioural therapy component.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251340407"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship among depressive symptoms, dyspnea-related fear and sarcopenia in patients with chronic obstructive pulmonary disease: The mediating effect of physical activity.","authors":"Wenxiu Wang, Lili Wang, Rongrong Fan, Li Xie, Jing Zhu","doi":"10.1177/14799731251335028","DOIUrl":"10.1177/14799731251335028","url":null,"abstract":"<p><p><b>Objectives:</b> Sarcopenia is influenced by multiple factors, including psychological aspects. This study aimed to explore the relationships among depressive symptoms, dyspnea-related fear, and sarcopenia, with a focus on the mediating role of physical activity. <b>Methods:</b> A cross-sectional study was conducted among 348 COPD patients at a tertiary hospital in Western China from July 2023 to July 2024. Sarcopenia was assessed according to the 2019 AWGS criteria, including hand bioelectrical impedance analysis (BIA), and grip strength testing. Depressive symptoms, dyspnea-related fear, and physical activity were evaluated through self-reported measures using the depression subscale of the Hospital Anxiety and Depression Scale (HADS), the Breathlessness Beliefs Questionnaire (BBQ), and the International Physical Activity Questionnaire Short Form (IPAQ-SF), respectively. Logistic regressions analyses explored associations among depressive symptoms, dyspnea-related fear, and sarcopenia. Maximum Likelihood (ML) estimation was employed using Mplus software to evaluate the mediating effect of physical activity on the relationships. <b>Results:</b> The prevalence of sarcopenia among COPD patients was 60.3%. In the logistic regression analysis with sarcopenia as the dependent variable, physical activity levels (OR = 0.508, <i>p</i> = 0.019) and depressive symptoms (OR = 1.079, <i>p</i> = 0.029) were statistically significant, while BBQ scores were not (OR = 1.031, <i>p</i> = 0.070). Mediating analyses revealed that depressive symptoms directly increased the risk of sarcopenia (β = 0.076, <i>p</i> = 0.042) but did not do so indirectly via physical activity (β = 0.056, <i>p</i> = 0.146). Conversely, dyspnea-related fear had an indirect effect on sarcopenia through physical activity, with a borderline statistical significance (β = 0.053, <i>p</i> = 0.049). <b>Conclusions:</b> This study highlights the critical role of psychological factors in sarcopenia development among COPD patients, with physical activity serving as a significant mediator. These findings underscore the need for integrated rehabilitation strategies addressing both psychological and physical activity barriers to improve outcomes for COPD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251335028"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies.","authors":"Mark Dransfield, Nathaniel Marchetti, Ravi Kalhan, Daniel Reyner, Amy L Dixon, Tara Rheault, Kathleen Ann Rickard, Antonio Anzueto","doi":"10.1177/14799731251314874","DOIUrl":"10.1177/14799731251314874","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of ensifentrine, a novel PDE3/PDE4 inhibitor, were previously evaluated in the ENHANCE-1 (NCT04535986) and ENHANCE-2 (NCT04542057) trials. Here, we present a pooled post-hoc subgroup analysis of patients according to background chronic obstructive pulmonary disease (COPD) maintenance medication regimens.</p><p><strong>Objective: </strong>This analysis aimed to explore the efficacy and safety of ensifentrine in patients receiving long-acting muscarinic antagonists (LAMA) or long-acting beta-agonists with inhaled corticosteroids (LABA + ICS).</p><p><strong>Methods: </strong>Eligible patients had moderate to severe COPD, were aged 40-80 years, and were symptomatic at randomization. Patients were randomized 5:3, receiving twice-daily ensifentrine 3 mg or placebo via standard jet nebulizer over 24 weeks.</p><p><strong>Results: </strong>The pooled post-hoc analysis included 485 LAMA patients and 272 LABA + ICS patients. Ensifentrine showed lung function improvement over placebo at week 12, including average FEV₁ AUC_0-12 h in the LAMA (placebo-corrected least squares mean change from baseline [LSMC], 92 mL; 95% CI, 54, 131; <i>p</i> < 0.001) and LABA + ICS subgroups (LSMC, 74 mL; 95% CI, 27, 121; <i>p</i> = 0.002). Ensifentrine reduced the rate and risk of exacerbations in both LAMA (48% and 50%, respectively) and LABA + ICS (51% and 56%, respectively) subgroups. Ensifentrine-treated patients reported improvement in symptoms and quality of life over 24 weeks. The safety profile of ensifentrine in each subgroup was similar to the profile in the pooled modified intention-to-treat population.</p><p><strong>Conclusions: </strong>Nebulized ensifentrine offers a novel non-steroidal anti-inflammatory and bronchodilator treatment added to existing LAMA or LABA + ICS treatment options in patients with moderate to severe, symptomatic COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251314874"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal mucosal keratosis: Case discussion and literature review.","authors":"Weiqiang Kong, Lu Zhao, Gongqi Chen, Chunli Huang, Wei Gu, Huiru Jie, Lingling Yi","doi":"10.1177/14799731241312412","DOIUrl":"10.1177/14799731241312412","url":null,"abstract":"<p><p>A 57-year-old female presented with a chief complaint of cough, with productive yellow sputum particularly severe in the morning. Bronchoscopy revealed inflammatory changes in both main bronchi, with abundant white purulent secretions and necrotic material adhering to the luminal surface. Histopathological examination showed chronic inflammatory changes in the mucosal tissue, with mild hyperplasia of the local squamous epithelium and evidence of keratinization in the surrounding area, consistent with a diagnosis of tracheal mucosal keratosis. The patient was treated with anti-infection therapy, combined with symptomatic supportive treatments such as cough suppression, expectorants, and bronchodilation, resulting in an improvement of symptoms. Analysis of previous literature revealed that although this condition lacks specific clinical manifestations and signs, it exhibits a typical pattern of tracheal wall lesions, and bronchoscopy and histopathological examination have high diagnostic value for this disease. Due to impaired airway mucosal barrier function, the patient is prone to bacterial infection or colonization in the airways. Symptomatic supportive treatment based on the actual condition can effectively alleviate the patient's clinical symptoms. Currently, there is no definitive curative treatment for tracheal mucosal keratosis. However, treatments such as high-frequency electrocautery, carbon dioxide cryotherapy, and repeated lavage with epidermal growth factors may be helpful in curing this condition.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731241312412"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is videoconference pulmonary rehabilitation associated with improvements in knowledge in people living with COPD? A propensity-matched service-evaluation.","authors":"Ching Yee Cheung, Wing Shing Yam, Melanie D Palmer, Stuart Clarke, William Dc Man, Nicola J Roberts, Claire M Nolan","doi":"10.1177/14799731241310895","DOIUrl":"10.1177/14799731241310895","url":null,"abstract":"<p><p><b>Introduction:</b> Pulmonary rehabilitation (PR) services are increasingly using alternative programme delivery modes, for example telerehabilitation strategies including videoconferencing, to improve patient choice and accessibility. Although telerehabilitation results in improvements in core outcomes, the effect on knowledge attainment is not known. <b>Aim:</b> To observe the real-world responses of patients choosing to undergo videoconference PR to a matched control group choosing to undergo in-person PR, in terms of knowledge attainment. <b>Methods:</b> Using propensity score matching, 25 people with COPD who completed videoconference PR were matched 1:1 with a control group of 25 people with COPD who completed in-person PR. Knowledge attainment was measured using the Lung Information Needs Questionnaire (LINQ). <b>Results:</b> There was a statistically and clinically significant improvement in LINQ score in both groups (mean (95%CI): videoconference -3.2 (-4.7 to -1.6); in-person -3.0 (-4.5 to -1.4)), with no significant between-group difference (mean (95%CI): 0.2 (-2.0 to -2.4)). 76% and 80% of participants achieved the minimal important difference of the LINQ in the videoconference and in-person PR groups respectively. <b>Conclusion:</b> In conclusion, this real-world service evaluation indicates that videoconference PR may be associated with similar improvements in knowledge attainment as in-person PR, but this requires corroboration due to the small sample size.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731241310895"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world disease burden, mortality, and healthcare resource utilization associated with bronchiectasis.","authors":"Sofia Shoaib, Joseph Feliciano, Elliott C Dasenbrook, Jason Maynard, Lakshmi Batchu, Maitreyee Mohanty, Melanie Lauterio, Alexandra J Feld","doi":"10.1177/14799731241310897","DOIUrl":"10.1177/14799731241310897","url":null,"abstract":"<p><strong>Objectives: </strong>To assess real-world survival and healthcare resource utilization (HCRU) in US patients with non-cystic fibrosis bronchiectasis (NCFBE).</p><p><strong>Methods: </strong>This retrospective analysis, using data from the STATinMED RWD Insights database from Jan 2015-Oct 2022, included adults with NCFBE (from Jan 2015-Oct 2021) and non-NCFBE comparators (from Jan 2015-Aug 2020); baseline characteristics were balanced by inverse probability treatment weighting. Outcomes included survival through end of study. HCRU was assessed over 12 months.</p><p><strong>Results: </strong>117,718 patients with NCFBE and 306,678 comparators were included. Patients with NCFBE had a 77% higher risk of death than comparators (hazard ratio [HR] 1.77 [95% CI 1.74-1.80]). Risk of death was higher among patients aged ≥65 years (vs 18-34 years; HR 11.03 [95% CI 10.36-11.74]), among Black patients (vs White; HR 1.53 [95% CI 1.50-1.55]), and among patients with comorbid COPD (HR 1.42 [95% CI 1.40-1.44]). Patients with NCFBE incurred higher all-cause and respiratory-related HCRU than comparators for outpatient office, outpatient hospital, emergency department (ED), inpatient and respiratory-related pulmonologist visits (all <i>p</i> < .0001); HCRU increased with exacerbations.</p><p><strong>Conclusions: </strong>Patients with NCFBE have high mortality burden and incur high HCRU, both of which are further increased with exacerbations. Prevention and delay of exacerbations are key areas for improvement of disease management.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731241310897"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational needs of people with COPD or asthma entering pulmonary rehabilitation and their significant others: A cross-sectional study.","authors":"Anouk Jl Muijsenberg, Sarah Houben-Wilke, Jan Tatousek, Joyca Lacroix, Martijn A Spruit, Daisy Ja Janssen","doi":"10.1177/14799731251316891","DOIUrl":"10.1177/14799731251316891","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to identify educational needs of people with COPD or asthma referred for pulmonary rehabilitation and their significant others. <b>Methods:</b> In this cross-sectional study, information needs were assessed by the Lung Information Needs Questionnaire. Learning styles were assessed with a multiple-choice question (visual, aural, read/write and kinaesthetic - multiple choices were possible). Psychological profiles were assessed by an instrument distinguishing four profiles: fighter, analyst, optimist or sensitive. <b>Results:</b> 121 patients (57% female; age: 65 ± 10 years; 81% COPD) and 67 significant others (55% female; age: 61 ± 12 years) were included. Patients and their significant others had a variety of information needs. Patients and their significant others mostly preferred the aural (39% and 49%, respectively) and read/write learning styles (31% and 36%, respectively) as unimodal learners. 49% of patients and 51% of significant others preferred more than one learning style. Most prevalent psychological profiles were optimist in patients (36%) and fighter in significant others (59%). <b>Discussion:</b> The identified variety in educational needs among people with COPD or asthma and their significant others underlines the importance of addressing this diversity of individual needs in education. Learners should have the opportunity to choose among a variety of topics and have access to multiple learning styles. Furthermore, educational interventions should consider to incorporate different communication strategies.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251316891"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and prognosis prediction in patients with AECOPD and type 2 diabetes mellitus: A multicenter observational study.","authors":"Xiaoqian Li, Qun Yi, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, Xianhua Li, Xiufang Xie, Pinhua Pan, Mengqiu Yi, Lina Cheng, Hui Zhou, Liang Liu, Chen Zhou, Jiarui Zhang, Lige Peng, Jiaqi Pu, Haixia Zhou","doi":"10.1177/14799731251325251","DOIUrl":"10.1177/14799731251325251","url":null,"abstract":"<p><p>ObjectivesDiabetes is a common comorbidity in COPD population. This study aimed to explore the impacts of T2DM on clinical characteristics and outcomes of patients with exacerbation of COPD, as well as develop a specified prognostic model for these patients.MethodsAECOPD patients were enrolled from a prospective, noninterventional, multicenter cohort study. Propensity score matching with a 1:2 ratio was performed to compare the characteristics and prognosis between patients with and without T2DM. Predictors for short-term mortality were determined by logistic regression analysis and a prediction nomogram were established and further validated in another cohort.ResultsA total of 1804 AECOPD patients with T2DM and 3608 matched patients without T2DM were included. AECOPD patients with T2DM presented with worse disease profile and prognosis. Eight independent predictors for short-term mortality were determined, including advanced age, disturbance of consciousness, chronic cardiac disease, low blood pressure, high heart rate, elevated neutrophil, urea nitrogen and random blood glucose. A prognostic nomogram was established with an AUC of 0.878 (95%CI: 0.842-0.915) in derivation cohort and 0.834 (95% CI: 0.767-0.901) in validation cohort, which was superior to DECAF (0.647 [95%CI: 0.535-0.760]) and BAP-65 score (0.758 [95%CI: 0.666-0.850]). The calibration curve and decision curve analysis also indicated its accuracy and applicability. Besides, a web calculator based on the nomogram was constructed to simplify the use of prognostic nomogram in clinical practice.ConclusionsComorbid diabetes is significantly associated with severe disease profile and worse prognosis in AECOPD population. Our nomogram may help to facilitate early risk assessment and proper decision-making among patients with AECOPD and T2DM.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251325251"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}