Journal of thoracic disease最新文献

{"title":"Impact of preoperative brain natriuretic peptide level for predicting postoperative respiratory complications.","authors":"Kentaro Miura, Shogo Ide, Masatoshi Minamisawa, Shuji Mishima, Daisuke Nakamura, Shunichiro Matsuoka, Hirotaka Kumeda, Takashi Eguchi, Kazutoshi Hamanaka, Koichiro Kuwahara, Kimihiro Shimizu","doi":"10.21037/jtd-24-1248","DOIUrl":"https://doi.org/10.21037/jtd-24-1248","url":null,"abstract":"<p><strong>Background: </strong>Predicting respiratory complications after pulmonary surgery is important for thoracic surgeons. This study aimed to clarify the relationship between preoperative brain natriuretic peptide (BNP) levels and postoperative respiratory complications (PRC).</p><p><strong>Methods: </strong>A total of 383 patients with primary or metastatic lung cancer who underwent surgical resection were included in this retrospective study. The cut-off value of elevated BNP was set as 35 pg/mL, and its relationship with PRCs was analyzed. Risk factors for PRCs were determined using a logistic regression model.</p><p><strong>Results: </strong>Among the patients, 66 (17%) experienced PRCs: 24% <i>vs.</i> 14% with BNP levels ≥35 and <35 pg/mL, respectively (P=0.02). In patients with a BNP level ≥35 pg/mL, the development of PRCs was higher in those who underwent lobectomy (34%) than in those who underwent sublobar resection (14%) (P=0.01). Univariate [odds ratio (OR): 1.947, 95% confidence interval (CI): 1.13-3.352, P=0.02] and multivariate (OR: 1.838, 95% CI: 1.032-3.273, P=0.04) analyses revealed a significant association between a preoperative BNP level ≥35 pg/mL and a higher risk of PRCs in all patients.</p><p><strong>Conclusions: </strong>Preoperative BNP levels ≥35 pg/mL were associated with an increased risk for PRCs, suggesting its potential utility for identifying patients with elevated risk for PRCs before pulmonary surgery.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8389-8398"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007678","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":"The blind spots on chest computed tomography: what do we miss.","authors":"Li Zhang, Xin Wen, Jing-Wen Ma, Jian-Wei Wang, Yao Huang, Ning Wu, Meng Li","doi":"10.21037/jtd-24-1125","DOIUrl":"10.21037/jtd-24-1125","url":null,"abstract":"<p><p>Chest computed tomography (CT) is the most frequently performed imaging examination worldwide. Compared with chest radiography, chest CT greatly improves the detection rate and diagnostic accuracy of chest lesions because of the absence of overlapping structures and is the best imaging technique for the observation of chest lesions. However, there are still frequently missed diagnoses during the interpretation process, especially in certain areas or \"blind spots\", which may possibly be overlooked by radiologists. Awareness of these blind spots is of great significance to avoid false negative results and potential adverse consequences for patients. In this review, we summarize the common blind spots identified in actual clinical practice, encompassing the central areas within the pulmonary parenchyma (including the perihilar regions, paramediastinal regions, and operative area after surgery), trachea and bronchus, pleura, heart, vascular structure, external mediastinal lymph nodes, thyroid, osseous structures, breast, and upper abdomen. In addition to careful review, clinicians can employ several techniques to mitigate or minimize errors arising from these blind spots in film interpretation and reporting. In this review, we also propose technical methods to reduce missed diagnoses, including advanced imaging post-processing techniques such as multiplanar reconstruction (MPR), maximum intensity projection (MIP), artificial intelligence (AI) and structured reporting which can significantly enhance the detection of lesions and improve diagnostic accuracy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8782-8795"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007466","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":"A new selective mediastinal lymph node dissection for clinical peripheral stage IA invasive non-small-cell lung cancer: a propensity-score matching study.","authors":"Hua He, Changsheng Yi, Wenteng Hu, Yu Zhou, Xiaofei Zeng, Quan Zhang, Shuo Sun, Ruijiang Lin, Peng Yue, Minjie Ma, Chang Chen","doi":"10.21037/jtd-24-1346","DOIUrl":"10.21037/jtd-24-1346","url":null,"abstract":"<p><strong>Background: </strong>The optimal extent of lymph node resection for early-stage non-small cell lung cancer (NSCLC) remains a topic of debate in the medical community. We aimed to assess the surgical and prognostic outcomes based on the extent of mediastinal lymph node dissection (MLND) for resectable clinical stage IA NSCLC.</p><p><strong>Methods: </strong>From 2016 to 2018, 1,166 patients with clinical stage IA NSCLC who underwent lobectomy or segmentectomy with complete mediastinal lymph node dissection (C-MLND) or selective mediastinal lymph node dissection (S-MLND) at five hospitals were enrolled. Propensity score matching (PSM) was used to reduce selection bias. Perioperative parameters, postoperative complications, survival and disease control were compared between the groups.</p><p><strong>Results: </strong>S-MLND and C-MLND were performed on 197 and 969 patients, respectively. After PSM, each group comprised 126 patients and there was no significant difference in 5-year recurrence-free survival (RFS) (C-MLND <i>vs.</i> S-MLND, 87.5% <i>vs.</i> 82.9%; P=0.32) or overall survival (OS) (C-MLND <i>vs.</i> S-MLND, 92.0% <i>vs.</i> 95.9%; P=0.39) between the groups. Similar results were observed for perioperative parameters, pN2 detection (6.3% <i>vs.</i> 4.8%, P=0.11) and recurrence patterns (P=0.28). However, the incidence of postoperative complications was significantly lower in the S-MLND cohort than that in the C-MLND cohort (12.7% <i>vs.</i> 23.0%, P=0.03).</p><p><strong>Conclusions: </strong>S-MLND demonstrated outcomes that were comparable to those of C-MLND and a reduction in complications, indicating the potential of S-MLND as an alternative approach for selected patients with stage IA NSCLC. Prospective, randomized trials are recommended to confirm these findings and establish clear clinical guidelines.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8280-8291"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007756","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":"Current status of pulmonary rehabilitation and impact on prognosis of patients with idiopathic pulmonary fibrosis in South Korea.","authors":"Jung Hyun Nam, Kyung Joo Kim, Chin Kook Rhee, Joon Young Choi, Yong Suk Jo","doi":"10.21037/jtd-24-1165","DOIUrl":"https://doi.org/10.21037/jtd-24-1165","url":null,"abstract":"<p><strong>Background: </strong>The benefits of pulmonary rehabilitation (PR) for patients with idiopathic pulmonary fibrosis (IPF) have been limited to improving dyspnea, exercise capacity, and quality of life (QoL). This study aimed to assess the current status of PR and its effect on prognosis.</p><p><strong>Methods: </strong>The Nationwide Korean Health Insurance Review and Assessment Service (HIRA) database was used in this study. Annual PR implementation rate since 2016 following its coverage in the health insurance was analyzed. IPF cases were defined using the International Classification of Diseases 10^th Revision (ICD-10) codes and rare intractable diseases (RID) codes. Risk of acute exacerbation (AE) and mortality of IPF patients with or without PR were analyzed.</p><p><strong>Results: </strong>Of the 4,228 patients with IPF, only 205 (4.85%) received PR. Patients in the PR group were more frequently treated with pirfenidone and systemic steroids than non-PR group. In patients treated with steroids, mortality risk increased regardless of PR application, with hazard ratio (HR) of 1.63 [95% confidence interval (CI): 1.26-2.10, P<0.001] in the PR group and 1.38 (95% CI: 1.21-1.57, P<0.001) in the non-PR group, compared to those not treated with steroids. Additionally, PR did not significant affect mortality risk in patients not receiving steroids (HR, 1.49, 95% CI: 0.87-2.54, P=0.15). Similar patterns were seen for the risk of AE.</p><p><strong>Conclusions: </strong>PR was applied in only a minority of patients with IPF. It did not succeed in reducing the risk of AE or mortality. A prospective study targeting early-stage patients is needed to evaluate the impact of PR considering the progressive nature of IPF disease itself.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8379-8388"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007631","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":"Preoperative vascular dysfunction is associated with acute kidney injury after cardiac surgery.","authors":"Daijiro Hori, Takahiro Yamamoto, Takeshi Kakiuchi, Atsushi Yamaguchi","doi":"10.21037/jtd-24-1291","DOIUrl":"https://doi.org/10.21037/jtd-24-1291","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery-associated acute kidney injury (CSA-AKI) results in poor prognosis. Several risk factors for CSA-AKI have been reported, including preoperative creatinine level, cardiopulmonary bypass time, and perioperative blood pressure management. Only few studies have reported the effect of vascular stiffness on the incidence of CSA-AKI, and there are is no study reporting on endothelial function and its association with CSA-AKI. The purpose of this study was to evaluate the association between preoperative vascular function, including vascular stiffness and endothelial function, and incidence of CSA-AKI.</p><p><strong>Methods: </strong>In this prospective observational study, 40 consecutive patients undergoing valve surgery were enrolled. Flow-mediated dilation (FMD) and pulse wave velocity (PWV) were measured before surgery for the evaluation of endothelial function and vascular stiffness. Blood test was also performed for the measurement of serum biomarkers including asymmetric dimethylarginine (ADMA) and vascular cell adhesion molecule-1 (VCAM-1). CSA-AKI was diagnosed by using the Kidney Disease Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>The mean age of the patients was 72±8.2 years old and 60% were male. All patients underwent valve surgery with two patients undergoing concomitant coronary artery bypass grafting. Preoperative FMD and PWV were 6.3%±2.58% and 1,554±386.6 cm/s respectively. ADMA and VCAM-1 were significantly correlated (r=0.50, P=0.001), and there was a significant correlation between FMD and ADMA (r=-0.42, P=0.007), and FMD and VCAM-1 (r=-0.42, P=0.007). Eleven patients (27.5%) developed CSA-AKI. FMD was lower in patients with CSA-AKI (no AKI: 6.9%±2.57% <i>vs.</i> AKI: 4.6%±1.77%, P=0.009) and PWV was higher in patients with CSA-AKI (no AKI: 1,467±296.4 cm/s <i>vs.</i> AKI: 1,784±506.7 cm/s, P=0.02). Further, VCAM-1 was higher in patients with CSA-AKI (no AKI: 696±247.5 ng/mL <i>vs.</i> AKI: 879±196.2 ng/mL, P=0.03). Multivariable analysis showed that preoperative FMD was an independent risk factor for CSA-AKI (odds ratio: 0.54, P=0.049).</p><p><strong>Conclusions: </strong>VCAM-1, FMD, and PWV were associated with incidence of CSA-AKI. These measurements may be useful in evaluation of potential risk of CSA-AKI in patients undergoing valve surgery.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8271-8279"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007778","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":"Relation between uric acid and stroke in aortic dissection.","authors":"Peiquan Li, Shaopeng Zhang, Tongyun Chen, Feng Zhao, Boyu Huang, Jianyu Wang, Nan Jiang, Yunpeng Bai, Qingliang Chen","doi":"10.21037/jtd-24-1383","DOIUrl":"https://doi.org/10.21037/jtd-24-1383","url":null,"abstract":"<p><strong>Background: </strong>Stroke is one of the severe complications following surgery in patients with acute type A aortic dissection (ATAAD). This study investigates the relationship between the preoperative serum uric acid to serum creatinine ratio (SUA/Scr) and postoperative stroke in patients undergoing total arch replacement with elephant trunk implantation for aortic dissection.</p><p><strong>Methods: </strong>We included ATAAD patients who were hospitalized and underwent surgery between June 1, 2015 and June 1, 2023, with complete clinical information. Preoperative SUA and Scr levels were collected to calculate SUA/Scr. The association between SUA/Scr and postoperative stroke was analyzed using univariate and multivariate logistic regression, as well as subgroup analysis. The optimal cut-off value of SUA/Scr was determined by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 332 patients were included in the study. Patients who developed postoperative stroke had lower SUA/Scr compared to those who did not (P=0.03). Univariate logistic regression indicated that higher SUA/Scr was associated with a reduced risk of postoperative stroke [odds ratio (OR) =0.80; 95% confidence interval (CI): 0.65-0.98; P=0.03]. This association remained significant after adjusting for confounding factors (OR =0.66; 95% CI: 0.45-0.97; P=0.04). Subgroup analysis revealed that the association between higher SUA/Scr and reduced risk of postoperative stroke was significant only in male patients (OR =0.81; 95% CI: 0.65-1.01; P=0.046) and those younger than 65 years (OR =0.82; 95% CI: 0.66-1.02; P=0.048), and was observed only in patients who underwent non-axillary artery cannulation (OR =0.65; 95% CI: 0.50-0.84; P=0.001), left femoral artery cannulation (OR =0.74; 95% CI: 0.58-0.96; P=0.02), and bilateral cerebral perfusion (OR =0.51; 95% CI: 0.32-0.81; P=0.004). The ROC curve analysis identified 3.36 as the optimal cut-off value for SUA/Scr.</p><p><strong>Conclusions: </strong>A higher SUA/Scr is associated with a reduced risk of postoperative stroke in patients with aortic dissection undergoing total arch replacement with stented elephant trunk implantation and may serve as a potential predictor of postoperative stroke.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8204-8215"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007516","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":"Thoracoscopic anatomical sublobar resection for deep interlobar lung cancer with fused fissure.","authors":"Zhicheng He, Wenzheng Xu, Zhihua Li, Jianan Zheng, Qi Wang, Tianyu Jin, Xianglong Pan, Varad Kaprekar, Liang Chen, Weibing Wu","doi":"10.21037/jtd-24-84","DOIUrl":"https://doi.org/10.21037/jtd-24-84","url":null,"abstract":"<p><strong>Background: </strong>The technical challenges associated with the removal of small nodules in challenging locations rather than peripheral locations remain unaddressed. We sought to illustrate the parenchymal-sparing surgical approach employed for deep interlobar lung cancer with fused fissures (DILCFFs).</p><p><strong>Methods: </strong>A retrospective review of 43 patients with cT1N0M0 DILCFFs from January 2013 through December 2022 was performed. Patients were grouped into the non-anatomical extended resection (NER): either a lobectomy or a (sub)segmentectomy for the predominant location with an extended wedge resection of a portion of an adjacent lobe, and the anatomical resection (AR): combined a lobectomy or a (sub)segmentectomy for the predominant location with a (sub)segmentectomy of an adjacent lobe.</p><p><strong>Results: </strong>In total, 17 patients underwent NER, 26 with AR. There were more cases undergoing preoperative nodule localization in the NER group. The AR arm conferred a wider surgical margin (2.52 <i>vs.</i> 1.27 cm, P<0.001) and a higher proportion of margin to tumor size ratio ≥1 (73.1% <i>vs.</i> 35.3%, P=0.01) than the NER arm. A total of 10 types of interlobar vessels within fused fissures were identified with an overall incidence of 88.4% (38/43). No patients in both arms experienced severe morbidity. Five patients allocated to the NER arm experienced local recurrence at the surgical margin, in comparison with zero in the AR arm (29.4% <i>vs.</i> 0%, P=0.006).</p><p><strong>Conclusions: </strong>AR of partial of the adjacent lobe provides a wider surgical margin than that of NER in the removal of DILCFFs, potentially accounting for the lower incidence of margin failure.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8162-8172"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007643","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":"Revealing age and gender as determinants of survival after pulmonary segmentectomy should represent just the beginning of more discovery.","authors":"James W Antonios, Anthony W Kim","doi":"10.21037/jtd-24-1537","DOIUrl":"https://doi.org/10.21037/jtd-24-1537","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8831-8835"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007526","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":"Erratum: Influence of hepatic dysfunction in patients who underwent tricuspid valve surgery.","authors":"","doi":"10.21037/jtd-2024-05","DOIUrl":"https://doi.org/10.21037/jtd-2024-05","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/jtd-22-1741.].</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8836"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007555","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":"Exploring risk factors for all-cause hospital readmissions following chronic obstructive pulmonary disease exacerbation patients discharged on steroid tapers.","authors":"Matthew Simpson, Rumbidzai Kapfumvuti, Sitara Niranjan, Matthew Sherman, Abdulahi Hassan, Erasmus Mutabi, Tyrell Daniel, Ravishankar Ranganatha, Kojo-Frimpong Awuah, Haris Paul, Yue Yin, Brandon Hoffman, Divya Venkat","doi":"10.21037/jtd-24-932","DOIUrl":"https://doi.org/10.21037/jtd-24-932","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) exacerbations often lead to hospitalizations and subsequent readmissions. Steroid therapy is a common approach in managing COPD exacerbations, yet a considerable proportion of patients experience readmissions within a short timeframe, highlighting the persistent and complex nature of COPD exacerbations. The aim of this retrospective study is to investigate risk factors for all-cause hospital readmissions in COPD patients discharged on steroid tapers following exacerbations, emphasizing the need for personalized management strategies to reduce readmission rates.</p><p><strong>Methods: </strong>Patient demographics and treatment histories were collected in a retrospective study of electronic medical records for patients in our hospital system for the calendar year 2023. Descriptive statistics were calculated, and univariate logistic regression were conducted for potential predictors.</p><p><strong>Results: </strong>Data analysis revealed that higher exacerbation frequency significantly increased the likelihood of readmission within a year, with patients experiencing three or more exacerbations facing 11 times and 25 times greater risks compared to those with 0 exacerbations. Early re-exacerbations within 30 days of discharge also emerged as strong predictors of long-term prognosis.</p><p><strong>Conclusions: </strong>Existing prognostic tools lack specificity for predicting short-term readmissions, highlighting the need for comprehensive risk assessment tools tailored to individual patient needs. Proactive monitoring of exacerbation frequency and personalized management strategies are essential for optimizing care delivery and reducing readmission rates in COPD patients. Targeted interventions aimed at mitigating identified risk factors and optimizing post-discharge management can enhance patient outcomes and alleviate the overall burden of COPD on patients and healthcare systems. Further research is warranted to address limitations and refine risk assessment tools to support personalized COPD care.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8538-8549"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007574","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}