Respiration最新文献

{"title":"Local anaesthetic thoracoscopy practice in the United Kingdom in 2024 - a snapshot survey.","authors":"Richard Westley, Avinash Aujayeb, Rahul Bhatnagar, Duneesha De Fonseka","doi":"10.1159/000546341","DOIUrl":"https://doi.org/10.1159/000546341","url":null,"abstract":"<p><strong>Introduction: </strong>Local anaesthetic thoracoscopy (LAT) is widely available in the United Kingdom (UK). It is often the investigation of choice for unexplained exudative pleural effusions. There are no agreed national standards regarding LAT, with many sites following locally developed guidelines. The last survey of UK practice was in 2017.</p><p><strong>Methods: </strong>An electronic survey was circulated to UK Pleural Society (UKPS) members and through direct communication with centres known to be undertaking LAT. Invited centres were requested to distribute the survey further.</p><p><strong>Results: </strong>37 responses were included. LAT remains the preferred investigation for an undiagnosed exudative pleural effusion (32/37, 87%). The number of trained thoracoscopists ranged from 1 to 6. Thirty centres (81%) had dedicated thoracoscopy lists with varying frequency. Nineteen (51%) centres routinely admitted patients post thoracoscopy (compared to 76% in 2017). Thirty centres (81%) did not routinely administer antibiotics. Thirty-five centres (95%) routinely used sedation, the commonest agent being midazolam, typically in combination with an opiate. Eleven centres (30%) utilised other pre-medications, whilst 8/37 (22%) of centres administered intravenous fluids. Where a minimal effusion is present 27/37 (73%) would induce a pneumothorax. Eleven (29%) centres would perform LAT for pleural infection. Only 11/37 (30%) of centres have on-site thoracic surgical support.</p><p><strong>Conclusions: </strong>There is wide variation in LAT practice amongst UK centres. These results support the need for identifying best practice and standardisation of LAT practices, with outcome reporting. These survey results will form the basis of applications to the national and international respiratory societies to develop relevant standards.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-13"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional collaboration and job satisfaction in German intensive care units - a cross-sectional survey within the PRiVENT project.","authors":"Thomas Fleischhauer, Elena Biehler, Julia Dorothea Michels-Zetsche, Franziska C Trudzinski, Janina Schubert-Haack, Johanna Forstner, Armin Schneider, Axel Kempa, Biljana Joves, Claus Neurohr, Felix Jf Herth, Joachim Szecsenyi, Michel Wensing","doi":"10.1159/000546043","DOIUrl":"https://doi.org/10.1159/000546043","url":null,"abstract":"<p><strong>Background: </strong>The multicentre cluster-randomized PRiVENT study aims to improve weaning of long-term ventilated patients in German intensive care units via a complex interprofessional intervention. To assess perceptions on interprofessional collaboration and job satisfaction among different health professions, a survey was conducted in four clusters, each comprising one weaning centre and 7-12 cooperation hospitals.</p><p><strong>Methods: </strong>Three validated questionnaires were used to measure a) interprofessional socialization (7-level Likert scale), b) interprofessional collaboration (5-level) and c) job satisfaction (7-level). Alongside a descriptive analysis, a subgroup analysis was performed comparing mean scores between physicians and non-physicians and the four clusters. Correlation coefficients were calculated to check for correlations of age group and work experience with interprofessional collaboration and job satisfaction.</p><p><strong>Results: </strong>62 questionnaires were returned by health workers of the intensive care units, corresponding to a response rate of 47%. Respondents rated interprofessional socialization (5.7 ± 0.6 ) and collaboration (3.8 ± 0.6) as good. Job satisfaction was high (5.1 ± 1.0), particularly regarding the collegial environment and variety of work tasks. Satisfaction with physical workload, income, and working hours was lower. Compared to physicians, overall ratings of non-physicians were lower, although the differences were not statistically significant, as were those between clusters. There was a statistically significant positive correlation of age group and work experience with overall job satisfaction.</p><p><strong>Conclusions: </strong>Health workers within PRiVENT are satisfied with their workplace conditions and rate interprofessional collaboration as good. Follow-up surveys will provide insights into the impact of PRiVENT on interprofessional cooperation and job satisfaction.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-18"},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report Series and Mini Review on Tuberculosis in IVF-ET Pregnancies: A Call for Vigilant Monitoring and Early Intervention.","authors":"Ju Zou, Jie Li, Xiaoxu Wang, Min Liu, Jiawang Chen, Ling Wang, Yongguo Du, Ruochan Chen","doi":"10.1159/000546340","DOIUrl":"https://doi.org/10.1159/000546340","url":null,"abstract":"<p><strong>Background: </strong>The risk of tuberculosis during pregnancy is significantly increased, and untimely Mycobacterium tuberculosis (M. tuberculosis) treatment during pregnancy increases the risk of perinatal complications and poor fetal prognosis. Hormonal use in vitro fertilization and embryo transfer (IVF-ET) promotes the growth of M. tuberculosis, leading to more severe disease and adverse pregnancy outcomes. However, its clinical characteristics and possible mechanisms of TB infection in pregnant women who conceive by IVF-ET remain unclear. Therefore, we report three cases of young pregnant women diagnosed with TB after IVF-ET and describe their diagnosis and treatment.</p><p><strong>Case presentation: </strong>Three young women (age: 26-31 years) diagnosed with primary infertility underwent IVF-ET treatment. They lacked a history of TB or manifestations of activated TB before transplantation. After presenting with fever, cough, and headache at 5-12 weeks of pregnancy, they were diagnosed with miliary TB, disseminated TB, and tuberculous meningitis, respectively. Initially, the patients were on a daily fixed-dose combination of first-line anti-TB treatment (ATT), which comprised rifampicin, isoniazid, pyrazinamide, and ethambutol, followed by medication adjustment during treatment for 6-12 months. Although all fetuses were lost, the patients achieved optimal outcomes after timely ATT.</p><p><strong>Conclusions: </strong>This report demonstrates the increased risk of TB in pregnant women who conceive by IVF-ET. Therefore, it is important to carefully monitor these women even if they lack a history of or exposure to TB. Accordingly, prompt diagnosis and treatment of TB in these patients is necessary to optimize patient outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-20"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SSP/SSTS - SSSSC JOINT ANNUAL MEETING 2025 Palexpo Geneva, Switzerland, 15 - 16 May 2025.","authors":"Valentina Vögtlin","doi":"10.1159/000545608","DOIUrl":"https://doi.org/10.1159/000545608","url":null,"abstract":"","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the BQQ Questionnaire for Assessing Bronchoscopists' Perception of Single-use Flexible Bronchoscope Quality.","authors":"Javier Flandes, Lina V Cerchiaro-Torrado, Carlos Disdier, Javier Alfayate, Iker Fernandez-Navamuel, Carlos Augustí, Carmen M Lucena, Francisco Martinez-Muñiz, Virginia Pajares, Felipe Andreo, Carmen Centeno, Carmen Montero, Miguel Ariza, Eduardo Tuta-Quintero, Rocio Gallego, Alfons Torregó, Héctor González, Rosa Cordovilla, Blanca de Vega-Sanchez, Juan Cascón, J Javier García-López, Cristina L García-Gallo, Prudencio Díaz-Agero, Estefanía Luque-Crespo, María Pavón-Masa, Enrique Cases, José Robles, Ana María Uribe-Hernández, Luis F Giraldo-Cadavid","doi":"10.1159/000546088","DOIUrl":"https://doi.org/10.1159/000546088","url":null,"abstract":"<p><strong>Background: </strong>The risk of cross-infections (including SARS-Cov-2) and damage to the flexible bronchoscope has led to the development of single-use flexible bronchoscopes as a cost-effective alternative. It is necessary for the bronchoscopist to evaluate the perception of the quality of these devices to determine if their quality is satisfactory for the user.</p><p><strong>Objective: </strong>Construction and validation of a Bronchoscope Quality Questionnaire (BQQ) to evaluate the quality of the flexible bronchoscope perceived by the bronchoscopist.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in 21 pulmonology centres in Spain. A first version of the BQQ was carried out by a group of experts, the construct validity was evaluated, and a factor analysis reduced the number of items. Feasibility of the BQQ was assessed by a questionnaire, internal consistency by the Cronbach's alpha coefficient and intra- and interrater reliability by the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The final version of the BQQ was composed of six domains and 18 items. The median completion time was five minutes, and it was not difficult to understand the items. Cronbach's alpha was 0.89, the intrarater ICC was 0.70 (95% CI 0.56 to 0.79), and the interrater ICC was 0.64 (95% CI: 0.47 to 0.76).</p><p><strong>Conclusion: </strong>The BQQ showed good feasibility, internal consistency and intra- and interrater reliability, which makes it suitable for evaluating the quality of flexible bronchoscopes perceived by the bronchoscopist.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-15"},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIAGNOSTIC MANAGEMENT OF PEDIATRIC BRONCHIECTASIS: A LITERATURE REVIEW AND CLINICAL EXAMPLES.","authors":"Paola Faverio, Giovanni Franco, Valentina Landoni, Marta Nadalin, Davide Negri, Alessandro Tagliabue, Federica Acone, Francesca Cattaneo, Filippo Cipolla, Chiara Vimercati, Stefano Aliberti, Giovanna Lucchini, Adriana Cristina Balduzzi, Fabrizio Luppi","doi":"10.1159/000546030","DOIUrl":"https://doi.org/10.1159/000546030","url":null,"abstract":"<p><strong>Background: </strong>bronchiectasis is an often underdiagnosed chronic respiratory disease in children and adolescents. Recent international guidelines highlighted the management of bronchiectasis in pediatric patients in comparison to adults. The purpose of this manuscript is to review the diagnostic, etiological work-up and follow-up in children and adolescents with bronchiectasis, using real-life clinical cases that highlight the multidisciplinary approach required for this complex condition.</p><p><strong>Summary: </strong>the diagnostic process requires both thoracic imaging and a clinical evaluation with the addition of pulmonary function tests and microbiological exams, when possible. Specific work-up should include past medical history (e.g. recurrent pneumonia, otitis or extra-respiratory infections), including family history, testing for genetic diseases (e.g. cystic fibrosis), evaluation of airways abnormalities and obstruction (e.g. bronchial foreign body), exclusion of concomitant immunodeficiencies and conditions associated to impaired mucociliary clearance. Main comorbidities and possible etiological conditions include chronic pulmonary aspiration and gastro-esophageal reflux, upper respiratory tract and otologic diseases, particularly rhinosinusitis, otitis, and asthma. Patients should be followed up every 3 to 6 months, with closer monitoring for those with severe disease; transition to adult care should be individualized, with emphasis on patient education, treatment adherence and multidisciplinary support.</p><p><strong>Key messages: </strong>the diagnostic work-up for children and adolescents with bronchiectasis is challenging and requires input from multiple experts. Early detection of bronchiectasis is crucial for establishing effective diagnostic and therapeutic strategies and may help prevent further progression.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-22"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Eccentric Cycling on Oxygen Uptake and Hemodynamics in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Crossover Trial.","authors":"Aldo Kammerlander, Simon Raphael Schneider, Michael Furian, Esther Irene Schwarz, Mona Lichtblau, Silvia Ulrich, Julian Müller","doi":"10.1159/000545787","DOIUrl":"10.1159/000545787","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and contributes significantly to reduced quality of life due to symptoms such as dyspnea and exercise intolerance. Eccentric cycling exercise (ECC) has shown potential as an alternative to conventional concentric cycling exercise (CON) in cardiopulmonary disease, including COPD, as it has a lower metabolic demand and potentially allows for higher exercise intensity with less perceived exertion. We aimed to compare ventilatory and circulatory responses of COPD patients between ECC and CON at identical submaximal workloads.</p><p><strong>Methods: </strong>In a randomized-controlled crossover trial, 17 COPD patients (6 female, mean ± SD age 67 ± 7 years) completed identical submaximal stepwise incremental cycling tests using ECC and CON, each step increasing by 10 W. The main outcome was oxygen uptake (<inline-formula><mml:math id=\"m1\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi mathvariant=\"normal\">V</mml:mi><mml:mo>˙</mml:mo></mml:mover><mml:msub><mml:mi mathvariant=\"normal\">O</mml:mi><mml:mn>2</mml:mn></mml:msub></mml:mrow></mml:math></inline-formula>). Additional outcomes were breath-by-breath ergospirometric measurements including minute ventilation (<inline-formula><mml:math id=\"m2\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi mathvariant=\"normal\">V</mml:mi><mml:mo>˙</mml:mo></mml:mover><mml:mi mathvariant=\"normal\">E</mml:mi></mml:mrow></mml:math></inline-formula>) and hemodynamics by echocardiography at each step.</p><p><strong>Results: </strong>At a mean end-exercise intensity of 41.3 ± 3.5 W, ECC lowered <inline-formula><mml:math id=\"m3\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi mathvariant=\"normal\">V</mml:mi><mml:mo>˙</mml:mo></mml:mover><mml:msub><mml:mi mathvariant=\"normal\">O</mml:mi><mml:mn>2</mml:mn></mml:msub></mml:mrow></mml:math></inline-formula> by -122 mL/min (-25%, 95% CI: -213 to -47, p = 0.005) and <inline-formula><mml:math id=\"m4\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi mathvariant=\"normal\">V</mml:mi><mml:mo>˙</mml:mo></mml:mover><mml:mi mathvariant=\"normal\">E</mml:mi></mml:mrow></mml:math></inline-formula> by -5.7 L/min (-29%, 95% CI: -10.0 to -1.6, p = 0.012) compared to CON. Perceived dyspnea and leg fatigue did not differ. A trend toward reduced strain on the right ventricle was observed in ECC (37 ± 13 mm Hg ECC vs. 48 ± 7 mm Hg CON), but this was not significant (p = 0.063). No adverse events occurred.</p><p><strong>Conclusion: </strong>ECC allowed COPD patients to exercise at the same workload but with a lower metabolic and ventilatory demand compared to CON, suggesting it has the potential to further improve exercise capacity in pulmonary rehabilitation.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042064","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":"Anti-Inflammatory Activity of Ensifentrine: A Novel, Selective Dual Inhibitor of Phosphodiesterase 3 and Phosphodiesterase 4.","authors":"Domenico Spina, Lui Franciosi, Radhakrishnan Venkatasamy, David A Saint, Margot MacDonald-Berko, Tara Rheault","doi":"10.1159/000545645","DOIUrl":"10.1159/000545645","url":null,"abstract":"<p><p>Ensifentrine is a novel, low-molecular-weight molecule that is a selective, dual inhibitor of phosphodiesterase (PDE)3 and PDE4. Inhibition of PDE3 has been shown to relax airway smooth muscle and inhibition of PDE4 to inhibit inflammatory responses and to stimulate the cystic fibrosis transmembrane conductance regulator in human airway epithelial cells through accumulation of intracellular cyclic adenosine monophosphate. Additionally, the dual inhibition of PDE3 and PDE4 demonstrates enhanced or synergistic effects compared with inhibition of either PDE3 or PDE4 alone on contraction of airway smooth muscle and suppression of inflammatory responses. Ensifentrine inhalation suspension 3 mg was recently approved in the USA for the maintenance treatment of chronic obstructive pulmonary disease in adult patients and is marketed under the trade name Ohtuvayre™. This manuscript describes further evidence that ensifentrine is a selective dual inhibitor of both human PDE3 and PDE4 enzymes and that this drug has significant anti-inflammatory activity in vivo in both allergic guinea pigs and non-human primates. This dual bronchodilator and anti-inflammatory activity of ensifentrine makes it a promising strategy as a novel inhaled \"bifunctional\" drug for the treatment of obstructive and inflammatory diseases of the respiratory tract.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":3.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014611","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":"COPD Exacerbations and Airflow Obstruction Severity Pre- and Post-Pneumococcal Vaccination: A post hoc Analysis of the RETRIEVE Real-World Study.","authors":"Stavros Tryfon, Efthymia Papadopoulou, Polyanthi Papanastasiou, Alexandros Ginis, Konstantinos Kostikas","doi":"10.1159/000545232","DOIUrl":"10.1159/000545232","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Prevention of exacerbations is fundamental to COPD management.</p><p><strong>Methods: </strong>The RETRIEVE study was a multicenter, 7-year retrospective study (NCT03858348) of patients with spirometry confirmation of COPD, who received LABA/ICS for at least 1 year and either continued or escalated to open triple therapy, according to their physicians' judgment. In this post hoc analysis, we explored exacerbation rate and lung function pre- and post-pneumococcal vaccination in a real-world setting.</p><p><strong>Results: </strong>Among 466 COPD patients, 48.1% received LABA/ICS for a mean 32 months, while 51.9% received LABA/ICS for a mean 21 months and then escalated to open triple therapy. Patients treated solely with LABA/ICS presented a significant reduction in COPD exacerbations (incidence rate ratio 0.66, 95% confidence interval [0.56, 0.78]) and related hospitalizations (0.43 [0.25, 0.72]) after pneumococcal vaccination compared to pre-vaccination. High-risk patients, who ultimately escalated to triple therapy, presented no reduction in exacerbations post-vaccination compared to pre-vaccination, and their airflow obstruction tended to deteriorate over time post-vaccination while they received LABA/ICS. However, after escalation to open triple therapy, there was significant reduction in exacerbations (0.78 [0.66, 0.94]) and related hospitalizations (0.41 [0.26, 0.66]) post-vaccination compared to pre-vaccination. Pneumococcal vaccination rates increased from 2012 to 2018 in our study, exceeding 90% from 2015 onward. Preserved lung function potentially delayed vaccination.</p><p><strong>Conclusion: </strong>This post hoc analysis of the RETRIEVE real-world study highlights the importance of appropriate, personalized maintenance COPD treatment, along with pneumococcal vaccination, for the prevention of COPD exacerbations.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Immune-Inflammation Index Is Associated with Adverse Outcomes in Patients Hospitalized for AECOPD: A Multicenter Cohort Study.","authors":"Xueqing Chen, Shiman Liu, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, Xianhua Li, Pinhua Pan, Xiufang Xie, Mengqiu Yi, Lina Cheng, Hui Zhou, Jiarui Zhang, Lige Peng, Jiaqi Pu, Jiaxin Zeng, Qun Yi, Haixia Zhou","doi":"10.1159/000545267","DOIUrl":"10.1159/000545267","url":null,"abstract":"<p><strong>Introduction: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) are associated with increased morbidity and mortality. The novel inflammatory biomarker, systemic immune-inflammation index (SII), may have prognostic value. This study aimed to assess the association between SII and short-term and long-term adverse outcomes among AECOPD inpatients.</p><p><strong>Methods: </strong>This was a multicenter, retrospective analysis of a prospectively collected cohort of AECOPD inpatients. We initially compared SII and other clinical characteristics between survivors and non-survivors during hospitalization, adjusting for primary comorbidities using propensity score matching (PSM). We assessed the short-term and long-term adverse outcomes, particularly focusing on in-hospital mortality and 2-year all-cause mortality, across different levels of SII. Multivariate Cox analysis was employed to evaluate the associations of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) with in-hospital mortality of AECOPD patients. Restricted cubic spline (RCS) models investigated the nonlinear relationships between these biomarkers and in-hospital mortality. To compare the predictive values of SII, NLR, and PLR for in-hospital mortality, receiver operating characteristic (ROC) curve analysis was performed. Subgroup analysis was carried out to further determine the predictive capacity of SII among diverse subgroups.</p><p><strong>Results: </strong>The study included 12,551 AECOPD inpatients, among whom 180 (1.4%) died in hospital. Whether before or after PSM adjusting for comorbidities, the levels of SII, NLR, and PLR in non-survivors were significantly higher than those in survivors (all p < 0.001). Elevated SII levels (divided into quartiles) were associated with increased in-hospital mortality (Q1 vs. Q2 vs. Q3 vs. Q4: 0.6% vs. 0.8% vs. 1.5% vs. 2.8%) and 2-year all-cause mortality (15.4% vs. 22.6% vs. 22.2% vs. 27.8%), as well as other adverse outcomes (all p < 0.05). After adjusting for covariates, higher levels of SII and NLR consistently remained associated with increased in-hospital mortality. RCS analysis revealed a consistent linear relationship between SII and in-hospital mortality, while NLR and PLR exhibited nonlinear relationships. Furthermore, ROC curve analysis indicated that SII showed inferiority to NLR but superiority to PLR in predicting in-hospital mortality among AECOPD patients (area under the curve for SII vs. NLR vs. PLR: 0.670 vs. 0.731 vs. 0.609). Subgroup analysis revealed that the association between SII and in-hospital mortality varied across different subgroups.</p><p><strong>Conclusion: </strong>Elevated SII is associated with increased risks of short-term and long-term adverse outcomes in AECOPD inpatients, making it potential prognostic factor used to identify high-risk patients and guide the management of AECOPD.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-19"},"PeriodicalIF":3.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}