COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Changes in Exercise Capacity and Health-Related Quality of Life at Four and Eight Weeks of a Pulmonary Rehabilitation Program in People with COPD.","authors":"Joshua A Bishop,&nbsp;Lissa M Spencer,&nbsp;Tiffany J Dwyer,&nbsp;Zoe J McKeough,&nbsp;Amanda McAnulty,&nbsp;Jennifer A Alison","doi":"10.1080/15412555.2021.2013793","DOIUrl":"https://doi.org/10.1080/15412555.2021.2013793","url":null,"abstract":"<p><p>Pulmonary Rehabilitation (PR) is a key intervention in the management of people with chronic obstructive pulmonary disease (COPD), though few studies have assessed where changes in outcomes occur during a PR program. The aim of this study was to determine the changes in exercise capacity and health-related quality of life at four and eight weeks during a twice-weekly supervised PR program in people with COPD. Fifty participants with COPD were recruited and attended PR twice-weekly for eight weeks. The outcome measures were the endurance shuttle walk test (ESWT), six-minute walk distance (6MWD), St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT) and the Hospital Anxiety and Depression Scale (HADS) which were measured at baseline, four and eight weeks. Compared to baseline, at week four there were significant improvements in ESWT (mean difference [95%CI] 197 [89 to 305] seconds), 6MWD (22 [8 to 36] metres), SGRQ symptom score (-6 [-12 to -1] points) and SGRQ total score (-4 [-7 to -1] points). Between week four and eight there were further significant improvements in ESWT (94 [8 to 181] seconds) only. By week eight, ESWT, 6MWD, SGRQ symptoms and total score, and CAT had all improved significantly compared to baseline measures. This study demonstrated that participants with moderate to very severe COPD who participated in a twice weekly, eight-week PR program (16 sessions) had significant improvement in ESWT, 6MWD, SGRQ, and CAT score with the greatest improvements occurring in the first four weeks of the program.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.2013793 .</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"612-620"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39742046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysfunctional Bronchial Cilia Are a Feature of Chronic Obstructive Pulmonary Disease (COPD).","authors":"Biju Thomas,&nbsp;Mariko Siyue Koh,&nbsp;Christopher O'Callaghan,&nbsp;John Carson Allen,&nbsp;Andrew Rutman,&nbsp;Robert Anthony Hirst,&nbsp;John Connolly,&nbsp;Su Ying Low,&nbsp;Ong Thun How,&nbsp;Loo Chian Min,&nbsp;Wan Teck Lim,&nbsp;Lynette Lin Ean Oon,&nbsp;Qixian He,&nbsp;Oon Hoe Teoh,&nbsp;Therese Sophie Lapperre","doi":"10.1080/15412555.2021.1963695","DOIUrl":"https://doi.org/10.1080/15412555.2021.1963695","url":null,"abstract":"<p><p>Impaired mucociliary clearance may increase COPD exacerbation risk. We aimed to compare bronchial ciliary function and epithelial ultrastructure of COPD patients to healthy controls and explore its relationship to exacerbator phenotypes (frequent [FE] and infrequent [IFE] exacerbator). In this cross-sectional study, 16 COPD patients and 12 controls underwent bronchial brushings. Ciliary beat frequency (CBF) and dyskinesia index (DI; % of dyskinetic cilia) were assessed using digital high-speed video microscopy, and epithelial ultrastructure using transmission electron microscopy (TEM). Bronchial epithelium in COPD showed lower CBF and higher DI, compared to controls (median [IQR] CBF: 6.8 (6.1-7.2) Hz vs 8.5 (7.7-8.9) Hz, <i>p</i><0.001 and DI: 73.8 (60.7-89.8) % vs 14.5 (11.2-16.9) %, <i>p</i><0.001, respectively). This was true for FE and IFE phenotypes of COPD, which were similar in terms of bronchial CBF or DI. Subgroup analyses demonstrated lower CBF and higher DI in FE and IFE COPD phenotypes compared to controls, irrespective of smoking status. TEM showed more loss of cilia, extrusion of cells, cytoplasmic blebs and dead cells in COPD patients versus controls. Profound dysfunction of bronchial cilia is a feature of COPD irrespective of exacerbation phenotype and smoking status, which is likely to contribute to poor mucus clearance in COPD.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1963695 .</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"657-663"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39373360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Prescribing Opioids in the Management of Chronic Breathlessness in COPD: A Review.","authors":"Emma Keogh,&nbsp;E Mark Williams","doi":"10.1080/15412555.2021.2000956","DOIUrl":"https://doi.org/10.1080/15412555.2021.2000956","url":null,"abstract":"<p><p>In people with COPD breathlessness is a common symptom and if mistreated can result in poor physical health and reduced quality of life. While it is important to manage the breathlessness using non-pharmacological management, persistent breathlessness may be treated with opioids. However, some physicians are reluctant to prescribe opioids to manage breathlessness in COPD. The aim of this review is to report the views, attitudes and barriers (if any) of healthcare professionals towards using opioids to manage chronic breathlessness in COPD. A review of the relevant literature was undertaken, using CINAHL, ScienceDirect and PubMed databases. The selected literature was assessed for quality of study design and methods used. Eleven studies (three qualitative, three mixed-methods and five quantitative) were reviewed and three themes were identified. Opioid use for refractory breathlessness in COPD is likely under prescribed by health care professionals working in areas other than palliative care. Additionally, there is a lack of confidence in using opioids except in those with palliative care experience, who are more likely to believe opioids may be helpful. Barriers identified are a lack of training, education, inadequate guidelines and concerns surrounding respiratory depression and other side effects. Research on this topic is mainly comprised of interviews or surveys and is low to moderate quality. Further clinical trials are needed on this topic including the opinions of all prescribing health care professionals involved in the care of these patients. Additionally, guidelines should offer further advice on when to start opioids and which patients would benefit most from opioids.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"713-722"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39610456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Transient Opioid Use Increase Risk of Short-Term Respiratory Exacerbation among Older Adults with Chronic Obstructive Pulmonary Disease?","authors":"Sujith Ramachandran,&nbsp;Yiran Rong,&nbsp;Kaustuv Bhattacharya,&nbsp;Monika Salkar,&nbsp;Gerald McGwin,&nbsp;Yi Yang,&nbsp;John P Bentley","doi":"10.1080/15412555.2021.2013460","DOIUrl":"https://doi.org/10.1080/15412555.2021.2013460","url":null,"abstract":"<p><p>The objective of this study was to examine the association between transient opioid use and acute respiratory exacerbations among older Medicare beneficiaries with COPD. This study was conducted using national Medicare 5% sample administrative claims data between 2012 and 2016 and employed a case-crossover design. The date of eligible COPD exacerbation events was defined as the index date and the presence of opioid prescriptions during a 7-day exposure window prior to index date was compared to a set of 10 control periods, each 7-days long. The association between opioid exposure and COPD exacerbation was estimated using a conditional logistic regression with robust sandwich estimators, after accounting for known time-varying confounders. Among 16,290 eligible COPD exacerbations included in the study sample, the average patient age was 77.08 years, and 64.2% of events occurred in women. Transient exposure to opioids was associated with a 76% increase in the odds of an acute COPD exacerbation (OR: 1.76, 95%CI: 1.67-1.84), and each 25 mg increase in morphine milligram equivalent dose was associated with a 18% increase in the odds of exacerbation (OR: 1.18, 95% CI: 1.15-1.21). Effect estimates were consistent across subgroup analyses conducted among events identified in the emergency department versus hospital, and among individuals with a single exacerbation event versus those with multiple exacerbations. Transient exposure to opioids was associated with an increased short-term risk of respiratory exacerbation among older adults with COPD. Treatment decisions for breathlessness among individuals with COPD need to account for the benefit-risk profile of opioids.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.2013460 .</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"650-656"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Readmission Following Undifferentiated Acute Hypercapnic Respiratory Failure.","authors":"Giulia Cavalot,&nbsp;Vera Dounaevskaia,&nbsp;Fernando Vieira,&nbsp;Thomas Piraino,&nbsp;Remi Coudroy,&nbsp;Orla Smith,&nbsp;David A Hall,&nbsp;Karen E A Burns,&nbsp;Laurent Brochard","doi":"10.1080/15412555.2021.1990240","DOIUrl":"https://doi.org/10.1080/15412555.2021.1990240","url":null,"abstract":"<p><p>Patients with acute hypercapnic respiratory failure (AHRF) often require hospitalization and respiratory support. Early identification of patients at risk of readmission would be helpful. We evaluated 1-y readmission and mortality rates of patients admitted for undifferentiated AHRF and identified the impact of initial severity on clinically important outcomes. We retrospectively analyzed patients who presented with AHRF to the emergency department of St Michael's Hospital in 2017. We collected data about patients' characteristics, hospital admission, readmission and mortality one year after the index admission. We analyzed predictors of readmission and mortality and conducted a survival analysis comparing patients who did and did not receive ventilatory support. A cohort of 212 patients with AHRF who survived their hospital admission were analyzed. At one year, 150 patients (70.8%) were readmitted and 19 (9%) had died. Main diagnoses included chronic obstructive pulmonary disease (60%), congestive heart failure (36%), asthma (22%) and obesity (19%), and these categories of patients had similar 1 y readmission rates. One third had more than one coexisting chronic illness. Although comorbidities were more frequent in readmitted patients, only a history of previous hospital admissions remained associated with 1 y readmission and mortality in multivariate analysis. Need for ventilatory support at admission was not associated with higher 1 y probability of readmission or death. Undifferentiated AHRF is the presentation of multiple chronic illnesses. Patients who survive one episode of AHRF and with previous history of admission have the highest risk of readmission and death regardless of whether they receive ventilatory support during index admission.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"602-611"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39527219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple Therapy in COPD: Time for Adaptive Selection Trials.","authors":"Samy Suissa","doi":"10.1080/15412555.2021.1982886","DOIUrl":"https://doi.org/10.1080/15412555.2021.1982886","url":null,"abstract":"<p><p>Recent trials reported significant reductions in all-cause mortality with single-inhaler triple therapy for chronic obstructive pulmonary disease (COPD). However, reviews of these trials identified inconsistencies in the findings and methodological issues with the design and analysis, including the \"adverse impact of inhaled corticosteroid (ICS) withdrawal rather than the addition\" of the triple therapy. Indeed, ICS were discontinued in over 70% of the patients in these trials and 40% already using triple therapy, muddying the interpretation of the data. The \"adaptive\" clinical trial design is an efficient approach that allows continual modification of the study treatment allocation during follow-up. In this article, we propose the \"adaptive selection\" trial design, which applies the adaptive concept to the selection of patients into the trial by adapting the randomization choices to the treatment already used by the patients. With such a design, patients already on triple therapy would be excluded outright from trials of triple therapy effectiveness, while the others are randomly allocated to specific treatment arms according to their current treatment, avoiding issues of treatment withdrawal effects. Adaptive selection trials should be the norm for studies of COPD therapies. This approach would avoid the vexing effects of treatment withdrawal that have afflicted the recent triple therapy trials. This concept of adaptive selection has been applied in COPD to the question of whether patients can be safely de-escalated from ICS. It is time to also apply it to studies of the effectiveness of treatment escalation.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"597-601"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39453912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease: Facts and Perspectives.","authors":"Alain Lurie,&nbsp;Nicolas Roche","doi":"10.1080/15412555.2021.1950663","DOIUrl":"https://doi.org/10.1080/15412555.2021.1950663","url":null,"abstract":"<p><p>The co-occurrence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in the same patient, named the overlap syndrome (OS), was first described in 1985. Although the American Thoracic Society underlined the limited knowledge of OS, stated research priorities for this condition, and recommended a \"screening\" strategy to identify OSA in COPD patients with chronic stable hypercapnia, research studies on OS remain scarce. This review aims to summarize the current knowledge and perspectives related to OSA in COPD patients. OS prevalence is 1.0-3.6% in the general population, 3-66% in COPD patients, and 7-55% in OSA patients. OS patients may have worse sleep quality than those with OSA or COPD alone. Scoring hypopneas may be difficult in COPD patients; desaturation episodes may have origins in these patients, namely upper airway obstruction, hypoventilation during paradoxical sleep, ventilation/perfusion mismatches, and obesity. The apnea-hypopnea index is similar in OSA and OS patients. Desaturations may be greater and more prolonged in OS patients than in patients with COPD or OSA alone. Low body mass index, hyperinflation, and less collapsible airways reduce the risk of OSA in COPD patients. OSA is a risk factor for pulmonary hypertension in COPD patients. Whether OS increases mortality and morbidity risks compared to COPD or OSA alone remains to be confirmed. No guidelines currently recommend specific approaches to the treatment of OSA in patients with COPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 6","pages":"700-712"},"PeriodicalIF":2.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39476039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of Exertional Dyspnea in Patients with Mild COPD and a Low Resting DL_CO.","authors":"Matthew D James,&nbsp;Devin B Phillips,&nbsp;Amany F Elbehairy,&nbsp;Kathryn M Milne,&nbsp;Sandra G Vincent,&nbsp;Nicolle J Domnik,&nbsp;Juan P de Torres,&nbsp;J Alberto Neder,&nbsp;Denis E O'Donnell","doi":"10.1080/15412555.2021.1932782","DOIUrl":"https://doi.org/10.1080/15412555.2021.1932782","url":null,"abstract":"<p><p>Patients with mild chronic obstructive pulmonary disease (COPD) and lower resting diffusing capacity for carbon monoxide (DL_CO) often report troublesome dyspnea during exercise although the mechanisms are not clear. We postulated that in such individuals, exertional dyspnea is linked to relatively high inspiratory neural drive (IND) due, in part, to the effects of reduced ventilatory efficiency. This cross-sectional study included 28 patients with GOLD I COPD stratified into two groups with (<i>n</i> = 15) and without (<i>n</i> = 13) DL_CO less than the lower limit of normal (<LLN; Global Lung Function Initiative criteria) and 16 healthy controls. We compared dyspnea (Borg scale), IND (by diaphragm electromyography), ventilatory equivalent for CO₂ (<i>V̇</i>_E/<i>V̇</i>CO₂), and respiratory mechanics during incremental cycle exercise in the three groups. Spirometry and resting lung volumes were similar between COPD groups. During exercise, dyspnea, IND and <i>V̇</i>_E/<i>V̇</i>CO₂ were higher at equivalent work rates (WR) in the DL_CO<LLN group compared with the other two groups (all <i>p</i> < 0.05). In patients with DL_CO<LLN, severe respiratory mechanical constraints, indicated by end-inspiratory lung volume of approximately 90% of total lung capacity, occurred at a lower WR than the other two groups (<i>p</i> < 0.05). The dyspnea/IND relationship was similar across groups; therefore, the increased dyspnea at a standardized WR in the low DL_CO<LLN group reflected the higher corresponding IND. Higher dyspnea ratings in patients with mild COPD and DL_CO<LLN were associated with higher IND and <i>V̇</i>_E/<i>V̇</i>CO₂ at a given work rate. Higher ventilatory requirements in the DL_CO<LLN group accelerated dynamic mechanical abnormalities earlier in exercise, further increasing IND and dyspnea.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 5","pages":"501-510"},"PeriodicalIF":2.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39396216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review with Thematic Synthesis of the Experience of Hospitalization in People with Advanced Chronic Obstructive Pulmonary Disease.","authors":"Barathi Bakthavatsalu,&nbsp;Catherine Walshe,&nbsp;Jane Simpson","doi":"10.1080/15412555.2021.1971186","DOIUrl":"https://doi.org/10.1080/15412555.2021.1971186","url":null,"abstract":"<p><p>Hospital admissions are common for people with advanced chronic obstructive pulmonary disease (COPD). To provide effective, responsive care, it is important to understand how people experience hospitalization. The aim of this review was to explore the experience of hospitalization in people with advanced COPD, drawing from qualitative research data. Guided by a thematic synthesis approach, a systematic search of databases (<i>n</i> = 13) including PubMed, CINAHL, PsycINFO and ProQuest was undertaken from database inception to May 2020. Inclusion criteria included papers reporting qualitative research focused on any aspect of hospitalization for people with advanced COPD and reported in English language from peer reviewed journals. Following quality appraisal, relevant data were extracted, and a three-stage thematic synthesis method used to develop inductive themes. From 1935 papers, the 11 included studies focused on specific aspects of hospitalization (e.g., care and treatment), rather than the totality of the experience. Four analytical themes were identified: unpredictable hospitalization, benefits and burdens of treatment, overwhelming distress and the communicative attitude of staff. Hospitalization was unpredictable because of the frequent, sudden admissions required for acute breathlessness. Hospital could be perceived both as a safe place, due to immediate symptom relief, but also as a place for experiencing overwhelming distress. Breathlessness was the most difficult symptom experienced, causing physical and psychological distress. Both communication and attitudes of the staff could influence the experience. A holistic approach to the care of hospitalized individuals with advanced COPD is required to improve care.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1971186 .</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 5","pages":"576-584"},"PeriodicalIF":2.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39381412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Blood Markers at Admission for Predicting Community Acquired Pneumonia in Chronic Obstructive Pulmonary Disease.","authors":"Shupei Gao,&nbsp;Yifei Duan,&nbsp;Jinqing Chen,&nbsp;Jianmiao Wang","doi":"10.1080/15412555.2021.1976739","DOIUrl":"https://doi.org/10.1080/15412555.2021.1976739","url":null,"abstract":"<p><p>Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) and community acquired pneumonia (CAP) are two common acute attacks in COPD patients and it is not always easy to determine whether a COPD patient at admission has parenchymal infection or bronchial infection. Comprehensive comparison between AECOPD patients and CAP patients with COPD (COPD + CAP) can help us understand them better. We retrospectively collected the medical records of AECOPD and COPD + CAP patients. Systemic inflammation, eosinophilic inflammation, damage to other organs, common chronic comorbidities, structural changes, phenotype and endotype distributions and coagulation functions between two groups were compared and correlations of these characteristics in total subjects, AECOPD patients and COPD + CAP patients were analyzed. Logistic regression analysis was performed to select helpful biomarkers for distinguishing between them. Receiver operator characteristic (ROC) curve was plotted to assess the diagnostic value of selected biomarkers and their combination. A nomogram was established for the differential diagnosis of AECOPD and COPD + CAP. A total of 206 patients were included into our analysis. In these subjects, 104 patients were classified as AECOPD group and 102 patients were considered to have COPD + CAP mainly based on their chest CT scan results. The counts of eosinophils (EOS), basophils (BAS) and lymphocytes (LYM) and percentage of total white blood cell count, hemoglobin and hematocrit were increased in AECOPD patients compared with COPD + CAP patients. The counts of neutrophils (NEU) and percentage of total white blood cell count, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), fibrinogen, D-dimer and N-Terminal pro-brain natriuretic peptide (NT-proBNP) levels were increased in COPD + CAP patients. After logistic regression analysis, EOS < 0.5 × 10⁹/L, ESR ≥ 8 mm/H and NT-proBNP ≥ 100 pg/mL were selected as helpful biomarkers for diagnosis of COPD + CAP instead of AECOPD. Area under the ROC curve (AUC) of the combination of selected biomarkers was 0.764(0.698-0.829). A nomogram was established and the calibration curve suggested that fitting efficiency of the nomogram was good. AECOPD and COPD + CAP are markedly different, mainly reflected in eosinophilic inflammation, systemic inflammation and coagulation function. Correlations between some common inflammatory biomarkers are also different in the two groups. A nomogram was established to offer help to clinicians for differential diagnosis of these two diseases.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"18 5","pages":"557-566"},"PeriodicalIF":2.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39407696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}