Respiration最新文献

{"title":"Feasibility and Impact on Diagnosis of Peripheral Pulmonary Lesions under Real-Time Direct Vision by Iriscope®.","authors":"Borja Recalde-Zamacona, Javier Alfayate, Andrés Giménez-Velando, Gabriel Romero, Iker Fernández-Navamuel, Javier Flandes","doi":"10.1159/000541675","DOIUrl":"10.1159/000541675","url":null,"abstract":"<p><strong>Introduction: </strong>Interventional pneumology plays a crucial role in the diagnosis of peripheral pulmonary lesions (PPLs), offering a minimally invasive approach with a low risk of complications. Iriscope® is a novel device that provides a direct and real-time image of PPLs. The objective of this study was to demonstrate the feasibility and impact of Iriscope® in diagnosing PPLs by analyzing its ability to directly visualize lesions and support accurate sampling during radial probe endobronchial ultrasound (rEBUS) and electromagnetic navigation bronchoscopy (ENB) combined with rEBUS.</p><p><strong>Methods: </strong>A single-center prospective study was conducted from December 2022 to October 2023 on patients with suspicious PPLs. The diagnostic approach involved either rEBUS alone or in combination with ENB. In all cases, an additional novel technique called Iriscope® (Lys Medical, Charleroi, Belgium) was also applied. Iriscope® findings of each lesion were evaluated individually by three expert interventional pulmonologists.</p><p><strong>Results: </strong>Seventy PPLs suspected of malignancy were included in the study. The PPLs underwent examination by ENB combined with rEBUS (55) or by rEBUS alone (15). Diagnosis was obtained in 68.6% (48/70) of cases. Iriscope® provided a direct, real-time view of 57.1% (40/70) of PPLs with a positive predictive value of 92.5% (37/40). This technique was able to visualize 72% (39/54) of malignant lesions, while only 6.1% (1/16) of benign lesions showed pathologic changes. The most common findings observed with Iriscope® were mucosal thickening and infiltration (92.5%), increased capillary vascularization (82%), pale or grayish mucosa (72.5%), obstruction with accumulation of secretions (50%), and cobblestone mucosa (15%).</p><p><strong>Conclusion: </strong>Iriscope® is a promising technique in the diagnostic process of PPLs, providing real-time pathologic imaging that facilitates accurate sampling. Further studies are needed to evaluate success rate of Iriscope-mediated repositioning and to establish predictive patterns for malignant or even benign diseases.</p><p><strong>Introduction: </strong>Interventional pneumology plays a crucial role in the diagnosis of peripheral pulmonary lesions (PPLs), offering a minimally invasive approach with a low risk of complications. Iriscope® is a novel device that provides a direct and real-time image of PPLs. The objective of this study was to demonstrate the feasibility and impact of Iriscope® in diagnosing PPLs by analyzing its ability to directly visualize lesions and support accurate sampling during radial probe endobronchial ultrasound (rEBUS) and electromagnetic navigation bronchoscopy (ENB) combined with rEBUS.</p><p><strong>Methods: </strong>A single-center prospective study was conducted from December 2022 to October 2023 on patients with suspicious PPLs. The diagnostic approach involved either rEBUS alone or in combination with ENB. In all cases, ","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"124-132"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381530","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":"Diagnostic Yield and Complications of Ultrasound-Guided Trans-Thoracic Biopsies by Pulmonologists: A Single-Center Retrospective Study of Lesions with Pleural Contact.","authors":"Jean-Baptiste Lovato, Lyria Amari, Julie Tronchetti, Benjamin Coiffard, Sophie Laroumagne, Philippe Astoul, Hervé Dutau","doi":"10.1159/000542853","DOIUrl":"10.1159/000542853","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided trans-thoracic needle biopsy (US-TTNB) is a method of choice for the diagnostic management of peripheral lung lesions and pleural masses for pulmonologists. If complication risk factors and diagnostic yield have been well reported for CT-guided biopsies, publications for US-TTNB in this field are very scarce.</p><p><strong>Methods: </strong>The primary objective of this study was to describe the diagnostic yield of US-TTNB carried out by pulmonologists defined by a definitive histopathological diagnosis. Secondary objectives were to identify factors that may influence diagnostic yield and to describe complications of this procedure. Between September 2015 and December 2022, charts of consecutive patients presenting peripheral lesion with pleural contact and having undergone US-TTNB were retrospectively analyzed. ROC curves were performed to assess the probability of having a contributing biopsy (definitive histology) depending on scannographic measurements and the number of punctures. Univariate and then multivariate analyses were performed to look for variables associated with complications.</p><p><strong>Results: </strong>One hundred and fifty-nine patients were enrolled in this study. Among them, diagnosis was obtained for 140 patients (88% success rate). The histology was in favor of a neoplastic process in 96% of cases (135/140). Analysis of the ROC curves showed that the depth of the lesion (AUC 75%; 95% CI: 65-85; cut-off 3.0 cm), the width of the lesion (AUC 73%; 95% CI: 63-86; cut-off 3.9 cm), the pleural contact (AUC 68%; 95% CI: 57-80; cut-off 3.8 cm), and the number of biopsies (AUC 70%; 95% CI: 59-81; cut-off 3 biopsies) were the variables associated with diagnostic yield. Complications occurred for 27 patients (17%), mainly pneumothorax (6%), hemoptysis (6%), and sepsis (6%). Univariate analysis showed a significant association between pneumothorax and lesion depth (OR 0.68; 95% CI: 0.65-0.92; p = 0.03) with a predicted probability >5% for a depth <4 cm according to general linear model analysis. Univariate and multivariate analysis revealed a significant association between the number of biopsies and the risk of sepsis (OR 1.90; 95% CI: 1.19-3.26; p = 0.01) with a predicted probability >5% for more than 4 biopsies.</p><p><strong>Conclusion: </strong>US-TTNB is a reliable diagnostic procedure that can be performed by pulmonologists. The depth, width, pleural contact of the lesion, and the number of biopsies are key variables associated with diagnostic yield. The depth of the lesion is associated with the risk of pneumothorax, and the number of biopsies with the risk of pulmonary sepsis.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"290-302"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802025","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":"Comparing the Diagnostic Performance of Lung Ultrasonography and Chest Radiography for Detecting Pneumothorax in Patients with Trauma: A Meta-Analysis.","authors":"Bo Sheng, Lili Tao, Congbing Zhong, Ling Gao","doi":"10.1159/000540777","DOIUrl":"10.1159/000540777","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to compare the diagnostic performance of ultrasonography (US) and chest radiography for detecting pneumothorax in patients with trauma using a meta-analytic approach.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were systematically searched to identify eligible studies until March 2023. The diagnostic performance of US and chest radiography was assessed using sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Overall, 21 studies involving 4,087 patients with trauma were included. The overall sensitivity, specificity, PLR, NLR, diagnostic score, DOR, and AUC of US for detecting pneumothorax were 0.83, 0.99, 73.72, 0.17, 6.06, 427.80, and 0.99, respectively. The corresponding values of chest radiography for detecting pneumothorax were 0.37, 1.00, 175.59, 0.63, 5.63, 279.97, and 0.86. US was associated with a higher sensitivity (ratio: 2.24; 95% confidence interval [CI]: 1.70-2.95; p < 0.001) or AUC (ratio: 1.15; 95% CI: 1.11-1.19; p < 0.001) and lower NLR (ratio: 0.27; 95% CI: 0.17-0.43; p < 0.001) compared with chest radiography.</p><p><strong>Conclusion: </strong>Lung US was associated with better diagnostic performance than chest radiography for detecting pneumothorax in patients with trauma.</p><p><strong>Introduction: </strong>The objective of this study was to compare the diagnostic performance of ultrasonography (US) and chest radiography for detecting pneumothorax in patients with trauma using a meta-analytic approach.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were systematically searched to identify eligible studies until March 2023. The diagnostic performance of US and chest radiography was assessed using sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Overall, 21 studies involving 4,087 patients with trauma were included. The overall sensitivity, specificity, PLR, NLR, diagnostic score, DOR, and AUC of US for detecting pneumothorax were 0.83, 0.99, 73.72, 0.17, 6.06, 427.80, and 0.99, respectively. The corresponding values of chest radiography for detecting pneumothorax were 0.37, 1.00, 175.59, 0.63, 5.63, 279.97, and 0.86. US was associated with a higher sensitivity (ratio: 2.24; 95% confidence interval [CI]: 1.70-2.95; p < 0.001) or AUC (ratio: 1.15; 95% CI: 1.11-1.19; p < 0.001) and lower NLR (ratio: 0.27; 95% CI: 0.17-0.43; p < 0.001) compared with chest radiography.</p><p><strong>Conclusion: </strong>Lung US was associated with better diagnostic performance than chest radiography for detecting pneumothorax in patients with trauma.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"161-175"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352824","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":"Predicting Acute Exacerbation Phenotype in Chronic Obstructive Pulmonary Disease Patients Using VGG-16 Deep Learning.","authors":"Shengchuan Feng, Ran Zhang, Wenxiu Zhang, Yuqiong Yang, Aiqi Song, Jiawei Chen, Fengyan Wang, Jiaxuan Xu, Cuixia Liang, Xiaoyun Liang, Rongchang Chen, Zhenyu Liang","doi":"10.1159/000540383","DOIUrl":"10.1159/000540383","url":null,"abstract":"<p><strong>Introduction: </strong>Exacerbations of chronic obstructive pulmonary disease (COPD) have a significant impact on hospitalizations, morbidity, and mortality of patients. This study aimed to develop a model for predicting acute exacerbation in COPD patients (AECOPD) based on deep-learning (DL) features.</p><p><strong>Methods: </strong>We performed a retrospective study on 219 patients with COPD who underwent inspiratory and expiratory HRCT scans. By recording the acute respiratory events of the previous year, these patients were further divided into non-AECOPD group and AECOPD group according to the presence of acute exacerbation events. Sixty-nine quantitative CT (QCT) parameters of emphysema and airway were calculated by NeuLungCARE software, and 2,000 DL features were extracted by VGG-16 method. The logistic regression method was employed to identify AECOPD patients, and 29 patients of external validation cohort were used to access the robustness of the results.</p><p><strong>Results: </strong>The model 3-B achieved an area under the receiver operating characteristic curve (AUC) of 0.933 and 0.865 in the testing cohort and external validation cohort, respectively. Model 3-I obtained AUC of 0.895 in the testing cohort and AUC of 0.774 in the external validation cohort. Model 7-B combined clinical characteristics, QCT parameters, and DL features achieved the best performance with an AUC of 0.979 in the testing cohort and demonstrating robust predictability with an AUC of 0.932 in the external validation cohort. Likewise, model 7-I achieved an AUC of 0.938 and 0.872 in the testing cohort and external validation cohort, respectively.</p><p><strong>Conclusions: </strong>DL features extracted from HRCT scans can effectively predict acute exacerbation phenotype in COPD patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-14"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760650","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":"Mastery Learning Guided by Artificial Intelligence Is Superior to Directed Self-Regulated Learning in Flexible Bronchoscopy Training: An RCT.","authors":"Kristoffer Mazanti Cold, Wei Wei, Kaladerhan Agbontaen, Suveer Singh, Lars Konge","doi":"10.1159/000542045","DOIUrl":"10.1159/000542045","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based training has proven effective for learning flexible bronchoscopy. However, no studies have tested the efficacy of training toward established proficiency criteria, i.e., mastery learning (ML). We wish to test the effectiveness of ML compared to directed self-regulated learning (DSRL) on novice bronchoscopists' end-of-training performance.</p><p><strong>Methods: </strong>In a standardized simulated setting, novices without prior bronchoscopy experience were trained using an artificial intelligence (AI) guidance system that automatically recognizes the bronchial segments. They were randomized into two groups: the ML group and the DSRL group. The ML group was trained until they completed two procedures meeting the proficiency targets: 18 inspected segments, 18 structured progressions, <120-s procedure time. The DSRL group was trained until they no longer perceived any additional benefits from training. Both groups then did a finalizing test, without the AI guidance enabled.</p><p><strong>Results: </strong>A total of 24 participants completed the study, with 12 in each group. Both groups had a high mean number of inspected segments (ML = 17.2 segments, DSRL = 17.3 segments, p = 0.85) and structured progressions (ML = 15.5 progressions, DSRL = 14.8 progressions, p = 0.58), but the ML group performed the test procedure significantly faster (ML = 107 s, DSRL = 180 s, p < 0.001). The ML did not spend significantly longer time training (ML = 114 min, DSRL = 109 min, p = 0.84).</p><p><strong>Conclusions: </strong>ML is a very efficient training form allowing novice trainees to learn how to perform a thorough, systematic, and quick flexible bronchoscopy. ML does not require longer time spent training compared to DSRL, and we therefore recommend training of future bronchoscopists by this method.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"206-215"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473444","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":"Application of the Clinical Outcomes, Healthcare Resource Utilization, and Related Costs Model in Chronic Obstructive Pulmonary Disease Patients.","authors":"Carlos J Alvarez-Martinez, Jorge Vélez, Clara Goñi, Joaquín Sánchez-Covisa, Mónica Juárez-Campo, Luciano Escudero, José L Bernal, Nicolás Rosillo, Miguel Hernández, Héctor Bueno","doi":"10.1159/000541406","DOIUrl":"10.1159/000541406","url":null,"abstract":"<p><strong>Introduction: </strong>The change in prevalence and management of chronic obstructive pulmonary disease (COPD) led to changes in outcomes and costs. We aimed to assess current clinical outcomes, resource utilisation, and costs in COPD.</p><p><strong>Methods: </strong>Retrospective, observational study of a cohort of consecutive COPD patients who visited the emergency department (ED) of a large tertiary hospital in 2018. The study measured baseline characteristics, 30-day and 1-year mortality, readmission, re-ED visit rates, and costs using the Clinical Outcomes, HEalthcare REsource utilisatioN, and relaTed costs (COHERENT) model, validated for heart failure. This model, featuring a colour graphic system, tracks time spent in different clinical situations (home, ED, hospital), considering vital status, healthcare resource use, and related costs.</p><p><strong>Results: </strong>In 2018, 2,384 patients with a primary COPD diagnosis visited the ED. The average age was 76 years, with 40% women. Observed mortality rates were 7.6% in-hospital, 8.5% at 30 days, and 23.4% at 1 year. The readmission rates were 9.9% and 36.1%, respectively. The cohort's 1-year cost was approximately EUR 14.6 million (USD 15.95 million), with a median cost per patient of EUR 3,298 (USD 3,603.96). Hospitalisation incurred the highest costs, with initial hospitalisation and readmissions accounting for 44.7% and 42.6% of expenditures, respectively.</p><p><strong>Conclusion: </strong>One-year mortality and readmission rates for patients with COPD visiting the ED remain high with a significant economic impact on the health system. This burden justifies special programs to improve their care.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"151-160"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392887","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":"Clinical Value of Impulse Oscillometry in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.","authors":"Junjie Peng, Xiaohua Li, Hong Zhou, Tao Wang, Xiaoou Li, Lei Chen","doi":"10.1159/000541633","DOIUrl":"10.1159/000541633","url":null,"abstract":"<p><strong>Introduction: </strong>Impulse oscillometry (IOS) is an effortless test compared to spirometry. Numerous studies explored the role of IOS in spirometry-based chronic obstructive pulmonary disease (COPD), but most of them had limited sample sizes with poor statistical power. This systematic review and meta-analysis aimed to pool the individual data and quantitatively analyze the clinical value of IOS in COPD.</p><p><strong>Methods: </strong>PubMed, Web of Science, Ovid, Cochrane Library, China National Knowledge Internet, and Wanfang were searched for studies with comparisons of IOS indicators between COPD patients and healthy controls, including respiratory resistance at 5 Hz (R5) and 20 Hz (R20), difference between R5 and R20 (R5-R20), respiratory reactance at 5 Hz (X5), resonant frequency (Fres), and area of reactance (Ax). Meta-analyses were conducted to calculate the weighted mean differences (WMDs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>39 eligible studies were enrolled, involving 6,144 COPD patients and 4,611 healthy controls. Relative to healthy controls, COPD patients had significantly higher R5 (WMD: 0.17, 95% CI: 0.14, 0.20), R5-R20 (WMD: 0.13, 95% CI: 0.11, 0.15), Fres (WMD: 9.04, 95% CI: 7.66, 10.42), Ax (WMD: 1.24, 95% CI: 0.86, 1.61), and lower X5 (WMD: -0.15, 95% CI: -0.18, -0.11), and such differences became even greater as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage escalated. Pooled correlation coefficients presented that R5, R5-R20, Fres, and X5 were significantly related to post-bronchodilator forced expiratory volume in the first second (FEV1)/forced vital capacity ratio (meta r = -0.37, -0.45, -0.53, and 0.42, respectively) and FEV1 as a percentage of predicted value (meta r = -0.43, -0.54, -0.59, and 0.56, respectively).</p><p><strong>Conclusion: </strong>IOS may be a supplement to spirometry in diagnosing and assessing COPD, especially when spirometry is inappropriate. More well-designed, large sample-sized, prospective studies are warranted to establish an IOS-based criterion for COPD management.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"100-109"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372735","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":"Prediction Model of In-Hospital Death for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients Admitted to Intensive Care Unit: The PD-ICU Score.","authors":"Xiaoqian Li, Qun Yi, Yuanming Luo, Hailong Wei, Huiqing Ge, Huiguo Liu, Jianchu Zhang, Xianhua Li, Xiufang Xie, Pinhua Pan, Hui Zhou, Liang Liu, Chen Zhou, Jiarui Zhang, Lige Peng, Jiaqi Pu, Jianlin Yuan, Xueqing Chen, Yongjiang Tang, Haixia Zhou","doi":"10.1159/000541367","DOIUrl":"10.1159/000541367","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to intensive care unit (ICU) are exposed to poor clinical outcomes, and no specific prognostic models are available among this population. We aimed to develop and validate a risk score for prognosis prediction for these patients.</p><p><strong>Methods: </strong>This was a multicenter observation study. AECOPD patients admitted to ICU were included for model derivation from a prospective, multicenter cohort study. Logistic regression analysis was applied to identify independent predictors for in-hospital death and establish the prognostic risk score. The risk score was further validated and compared with DECAF, BAP-65, CURB-65, and APACHE II score in another multicenter cohort.</p><p><strong>Results: </strong>Five variables were identified as independent predictors for in-hospital death in APCOPD patients admitted to ICU, and a corresponding risk score (PD-ICU score) was established, which was composed of procalcitonin >0.5 μg/L, diastolic blood pressure <60 mm Hg, need for invasive mechanical ventilation, disturbance of consciousness, and blood urea nitrogen >7.2 mmol/L. Patients were classified into three risk categories according to the PD-ICU score. The in-hospital mortality of low-risk, intermediate-risk, and high-risk patients was 0.3%, 7.3%, and 27.9%, respectively. PD-ICU score displayed excellent discrimination ability with an area under the receiver-operating characteristic curve (AUC) of 0.815 in the derivation cohort and 0.754 in the validation cohort which outperformed other prognostic models.</p><p><strong>Conclusion: </strong>We derived and validated a simple and clinician-friendly prediction model (PD-ICU score) for in-hospital mortality among AECOPD patients admitted to ICU. With good performance and clinical practicability, this model may facilitate early risk stratification and optimal decision-making among these patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"85-99"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294161","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":"Ethics in Medical Device Development.","authors":"Felix J F Herth, Fabien Maldonado, Judith Brock","doi":"10.1159/000541963","DOIUrl":"10.1159/000541963","url":null,"abstract":"","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"69-71"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473443","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":"The Association between Preserved Ratio Impaired Spirometry and Depression: Results from a Prospective Population-Based Study.","authors":"Ping Lin, Xiaoqian Li, Faming Jiang, Zongan Liang","doi":"10.1159/000541212","DOIUrl":"10.1159/000541212","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between preserved ratio impaired spirometry (PRISm) and depression remains unclear. This study aimed to assess the bidirectional relationship between PRISm and depression using data from a national cohort.</p><p><strong>Methods: </strong>Data from wave 2 (2004-2005) to wave 4 (2008-2009) of the English Longitudinal Study of Ageing (ELSA) were analyzed. Lung function and depressive symptoms were measured at baseline and follow-up. Cox proportional hazard models were used to calculate the hazard ratio (HR) of PRISm with depression (study 1) and depression with PRISm (study 2).</p><p><strong>Results: </strong>Studies 1 and 2 included 2,934 and 2,277 participants, respectively. The follow-up period extended from wave 2 to wave 4. In univariate analyses, a bidirectional association between PRISm and depression was observed, with unadjusted HRs of 1.49 (95% confidence interval [CI], 1.12-1.99; p = 0.007) in study 1 and 1.69 (95% CI, 1.13-2.52; p = 0.010) in study 2. However, in multivariable Cox models, baseline PRISm was not associated with subsequent depression development (adjusted HR 1.26; 95% CI, 0.94-1.69; p = 0.128). Conversely, participants with depression had a significantly higher risk of developing PRISm compared to those without depression (adjusted HR 1.54; 95% CI, 1.03-2.32; p = 0.038). These findings were consistent with z-score-based interpretive strategies, with an adjusted HR of 1.30 (95% CI, 0.95-1.77; p = 0.105) in study 1 and 1.59 (95% CI, 1.03-2.47; p = 0.038) in study 2.</p><p><strong>Conclusions: </strong>Depression was associated with an increased risk of developing PRISm, whereas PRISm did not increase the risk of developing depression. Physicians should be vigilant for potential PRISm development in patients with depression.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"40-47"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120483","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}