Respiratory medicine最新文献

{"title":"Elevated HIF-1α as a Diagnostic Biomarker in COPD: Correlations with EPO, Emphysema Index, and Pulmonary Function.","authors":"Nurettin Andac Atalay, Burcu Yormaz, Ali Şahin, Gamze Sonmez, Sinem Suphan Colkesen, Husamettin Vatansev, Halil Ozer, Muslu Kazim Korez","doi":"10.1016/j.rmed.2025.108184","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108184","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with phenotypes including chronic bronchitis and emphysema. Hypoxia-inducible factor-1 alpha (HIF-1α) mediates cellular responses to hypoxia, while vascular endothelial growth factor (VEGF) promotes angiogenesis and erythropoietin (EPO) serves as a hypoxia-activated hematopoietic growth factor.</p><p><strong>Objectives: </strong>To determine the relationship among demographic characteristics, laboratory, and radiologic parameters, and HIF-1α, VEGF, EPO, LDH values of COPD phenotypes, and to reveal the relationship among the parameters.</p><p><strong>Methods: </strong>In this prospective study of 181 participants, clinical data, spirometry, and serum levels of HIF-1α, VEGF, and EPO were collected. ROC analysis determined optimal HIF-1α cutoffs for differentiating COPD from controls and for distinguishing COPD phenotypes. Correlations between HIF-1α and lung function parameters were assessed.</p><p><strong>Results: </strong>COPD patients exhibited significantly higher HIF-1α levels (954.25 ± 452.92 pg/mL) than controls (762.51 ± 393.99 pg/mL; p = 0.002). An optimal cutoff of 705.464 pg/mL yielded 66.67% sensitivity and 62.79% specificity for COPD diagnosis. For phenotype differentiation, a cutoff of 900 pg/mL distinguished emphysema from chronic bronchitis with 70% sensitivity and 65% specificity. HIF-1α showed a weak negative correlation with lung function (r = -0.17, p = 0.183) and did not vary significantly across GOLD stages (p = 0.462). A positive correlation with EPO levels was also noted.</p><p><strong>Conclusion: </strong>Elevated HIF-1α levels are associated with COPD and vary between its phenotypes, supporting its potential as a diagnostic biomarker. However, its limited correlation with disease severity suggests further research is needed.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108184"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187794","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 alpha-1-acid glycoprotein and asthma in United States: a cross-sectional study from NHANES","authors":"Xiaolan Zhang ,&nbsp;Xue Zhang ,&nbsp;Yu Wan ,&nbsp;Dongdong Xu ,&nbsp;Yujie Han ,&nbsp;Menmei Zhang","doi":"10.1016/j.rmed.2025.108174","DOIUrl":"10.1016/j.rmed.2025.108174","url":null,"abstract":"<div><h3>Background</h3><div>Alpha-1-acid glycoprotein (AGP), also known as orosomucoid (ORM), is an acute-phase protein associated with asthma. However, research on the relationship between AGP and asthma risk is limited. This study aims to investigate the association between AGP and asthma in the United States.</div></div><div><h3>Methods</h3><div>We used data from the National Health and Nutrition Examination Survey (NHANES) to examine the association between α-1-acid glycoprotein and asthma. The main analytical methods used in this study were multivariate logistic regression analysis, restricted cubic spline (RCS) analysis and stratified interaction analysis.</div></div><div><h3>Results</h3><div>This cross-sectional study of 2947 participants (weighted to represent 78,392,391 U S.population) comprised 2746 females (93.8 %) with age distribution of 1150 (30.5 %) aged &lt;20 years and 1797 (69.5 %) aged≥20 years. When analyzed as a continuous variable and after adjustment for potential confounders, there was a significant positive association between alpha-1-acid glycoprotein and prevalent asthma (OR: 2.81,95 % CI: 1.42–5.57, p &lt; 0.001). However, when alpha-1-acid glycoprotein was divided into tertiles and T1 was used as the reference group, asthma was only positively associated with the T3 group (range of alpha-1-acid glycoprotein: &gt;0.85 g/L). Specifically, each 1 g/L increase in alpha-1-acid glycoprotein increased the risk of asthma by 74 % (95 % CI: 1.08,2.82, p = 0.026). Stratified analyses by sex and socioeconomic status showed similar results.</div></div><div><h3>Conclusion</h3><div>In the United States, there is a positive association between higher levels of alpha-1 acid glycoprotein and the risk of asthma. However, more research is needed to explore the underlying mechanisms and to validate these findings in clinical settings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"245 ","pages":"Article 108174"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184674","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":"Secretion management devices reduce hospitalizations for respiratory exacerbation in children with neurodisability.","authors":"Jérôme Pradon, Audrey Barzic, Marc Lubrano Lavadera, Sonia Khirani, Coline Canavesio, Emmanuelle Fleurence, Géraldine Labouret, Guillaume Aubertin, Sophie Denamur, Jessica Taytard","doi":"10.1016/j.rmed.2025.108183","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108183","url":null,"abstract":"<p><strong>Background: </strong>Respiratory complications are the leading cause of morbidity and mortality in children with neurodisability. Repeated pulmonary infections lead to multiple hospitalizations. Effective secretion management is crucial in this population, but studies on their impact are limited. This study evaluates the effect of secretion management on the duration of hospitalizations for respiratory exacerbations in children with neurodisability.</p><p><strong>Methods: </strong>This retrospective observational multicenter study included children from four French reference centers, between February and May 2024, one year after initiating a secretion management device.</p><p><strong>Results: </strong>Twenty-three patients (9 girls) with a median age of 10.7 [8.7;15.3] years were included. Sixteen children had recurrent chest infections before initiating a secretion management technique. Intrapulmonary percussive ventilation (IPV), intermittent positive pressure breathing (IPPB), and mechanical insufflation-exsufflation (MI-E) devices were prescribed to 12, 7, and 5 children, respectively. The primary indication was repeated respiratory infections in 11 children, and thoracic mobilization in 8 children. One year after device initiation, the number of days of hospitalization for pulmonary exacerbation significantly decreased from a median (range) of 12 (0-88) to 0 (0-34) days (p=0.018).</p><p><strong>Conclusion: </strong>This multicenter study demonstrates that secretion management significantly reduces the duration of hospitalizations for respiratory exacerbations in children with neurodisability.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108183"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187795","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":"Comparative effectiveness of inhaled fluticasone propionate/salmeterol and budesonide/formoterol fixed-dose combinations in asthma control - a retrospective United States database analysis.","authors":"Nicola A Hanania, Richard Stanford, Adrian Rendon, Bilun Gemicioglu, Leandro Fritscher, Watchara Boonsawat, Anurita Mamjudar, Nnaemeka Odo, Mohamed Hamouda","doi":"10.1016/j.rmed.2025.108172","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108172","url":null,"abstract":"<p><strong>Background: </strong>Asthma affects over 260 million people globally, with significant health impacts. The Global Initiative for Asthma (GINA) 2024 report recommends inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) combinations, including fluticasone propionate/salmeterol (FP/SAL) and budesonide/formoterol (BUD/FOR), for maintenance treatment. Both combinations have demonstrated clinical benefits, with previous clinical trials and real-world studies showing comparable asthma control with FP/SAL and BUD/FOR. This United States (US)-based study compares the real-world effectiveness of FP/SAL and BUD/FOR on asthma control and treatment adherence.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from the US Optum's Market Clarity database (July 1, 2010, to December 31, 2019), with integrated medical, pharmacy claims, and clinical electronic health records. Patients aged ≥18 years with asthma at GINA Steps 3-4, and ≥1 pharmacy claim for FP/SAL or BUD/FOR (index) were included. Patients on other ICS/LABA therapy ≥12 months prior to index were excluded. Inverse probability of treatment weighting adjusted for confounders. Outcomes were stratified by asthma severity.</p><p><strong>Results: </strong>A total of 57,000 patients were included (FP/SAL: 28,639; BUD/FOR: 28,361). Baseline characteristics were balanced post-weighting. Asthma control was similar between cohorts, with no significant differences in Asthma Control Test scores or short-acting β₂-agonist fills during the 12-month period following the index. Treatment adherence, assessed using proportion of days covered (≥0.8), was higher in the FP/SAL cohort (5.4%) versus the BUD/FOR cohort (4.4%; p < 0.001).</p><p><strong>Conclusions: </strong>FP/SAL and BUD/FOR were similarly effective for asthma control in real-world settings, while FP/SAL was generally associated with greater medication adherence, a key factor for long-term control.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108172"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187793","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":"Characterizing the preserved ratio impaired spirometry phenotype in all severities of asthma","authors":"Marcello Cottini ,&nbsp;Remo Poto ,&nbsp;Atanu Bhattacharjee ,&nbsp;Stanley Galant ,&nbsp;Brian Lipworth ,&nbsp;Erol A. Gaillard ,&nbsp;Robert Greig ,&nbsp;Alvise Berti ,&nbsp;Carlo Lombardi ,&nbsp;Francesco Menzella ,&nbsp;Laura Ventura ,&nbsp;Pasquale Comberiati ,&nbsp;Rory Chan","doi":"10.1016/j.rmed.2025.108180","DOIUrl":"10.1016/j.rmed.2025.108180","url":null,"abstract":"<div><h3>Introduction</h3><div>The preserved ratio impaired spirometry (PRISm) phenotype is characterized by a maintained FEV₁/FVC ratio ≥70 but an abnormal FEV₁&lt;80 % predicted. Small airways dysfunction (SAD) is common amongst asthmatics and is associated with poorer clinical outcomes. SAD can be assessed using oscillometry as resistance between 5 and 20Hz (Rrs5-20), reactance at 5Hz (X5) and area under the reactance curve (AX). We aimed to investigate the prevalence of PRISm and its relationship with SAD in all severities of asthma with the primary outcome of annual exacerbation rate.</div></div><div><h3>Methods</h3><div>Data from the Oscillometry Asthma Registry comprising 937 adults with GINA-defined persistent asthma were retrospectively collected from two specialized asthma centres in UK and Italy. Multivariate analyses were performed using binary logistic regression to obtain adjusted odds ratios for the association between PRISm and exacerbation frequency and symptom control.</div></div><div><h3>Results</h3><div>PRISm had a 19.6 % prevalence in moderate-to-severe asthma and was associated with a greater likelihood of ≥1 exacerbation [OR 95 %CI 3.00 (1.80,5.00) p &lt; 0.001], ≥2 exacerbations [4.00 (1.86,8.59) p &lt; 0.001] and uncontrolled symptoms [14.04 (4.87,40.50) p &lt; 0.001] compared to patients with normal spirometry. Conversely, patients with PRISm were prescribed significantly lower ICS doses and had fewer exacerbations compared to those with airway obstruction.</div></div><div><h3>Conclusion</h3><div>The PRISm asthma phenotype is associated with greater exacerbation frequency, poorer symptom control and a higher SAD prevalence compared to patients with normal spirometry. Future research should focus on longitudinal follow-up to confirm the progression of PRISm to obstructive patterns and assess potential therapeutic interventions to modify this trajectory.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108180"},"PeriodicalIF":3.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167693","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 phenotypes predict exacerbations of COPD: the TIE cohort study","authors":"Jens Ellingsen ,&nbsp;Christer Janson ,&nbsp;Kristina Bröms ,&nbsp;Amir Farkhooy ,&nbsp;Maria Hårdstedt ,&nbsp;Marieann Högman ,&nbsp;Karin Lisspers ,&nbsp;Andreas Palm ,&nbsp;Björn Ställberg ,&nbsp;Andrei Malinovschi","doi":"10.1016/j.rmed.2025.108182","DOIUrl":"10.1016/j.rmed.2025.108182","url":null,"abstract":"<div><h3>Background</h3><div>In 2017, Burgel and colleagues developed an algorithm to identify clinical phenotypes that predict mortality in COPD. Our study aimed to 1) investigate whether the phenotypes can predict acute exacerbations of COPD (AECOPD) and 2) validate their ability to predict mortality.</div></div><div><h3>Methods</h3><div>The Tools Identifying Exacerbations (TIE) cohort study recruited participants with spirometry-verified COPD from primary and secondary care in three Swedish regions. Participants were allocated to phenotypes 1–5 using the previously developed algorithm containing comorbidities (heart failure, coronary artery disease, hypertension, and/or diabetes), dyspnoea, age, forced expiratory volume in 1 s (FEV₁), and body mass index (BMI). Data on AECOPDs and deaths during the three-year follow-up were collected from medical records and analysed with Cox proportional hazards regressions. Harrel's C-index was used to assess the models' discriminative ability.</div></div><div><h3>Results</h3><div>Among the 566 participants, 59 % were female, and the mean ± SD FEV₁ was 57 ± 18 % of predicted. The hazard ratios (HRs) [95 % CI] for time to AECOPD were 3.04 [1.93–4.79], 2.38 [1.54–3.66], and 3.52 [1.73–7.15] in phenotypes 1, 2, and 4 compared with 5 (C-index = 0.61). When AECOPD history was used to predict future AECOPD the C-index was 0.65.</div><div>The HRs [95 % CI] for mortality were 8.24 [1.93–35.3], 6.26 [1.40–28.0], and 16.7 [3.25–86.3] in phenotypes 1, 3, and 4 compared to 5 (C-index = 0.68). For AECOPD history, the C-index was 0.55.</div></div><div><h3>Conclusion</h3><div>Clinical COPD phenotypes based on comorbidities, dyspnoea, age, FEV₁, and BMI predict AECOPDs but do not perform better than AECOPD history. However, they perform better than AECOPD history in predicting mortality.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108182"},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147106","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 chronic kidney disease on survival in patients with chronic obstructive pulmonary disease","authors":"Chen-Chuan Hsu ,&nbsp;Pi-Hung Tung ,&nbsp;Ting-Yu Lin ,&nbsp;Shih-Wei Huang ,&nbsp;Tsu-Chuan Li ,&nbsp;Bing-Chen Wu ,&nbsp;Chiung-Hsin Chang ,&nbsp;Hao-Ming Wu ,&nbsp;Chun-Yu Lo ,&nbsp;Chun-Yu Lin ,&nbsp;Horng-Chyuan Lin ,&nbsp;Shu-Min Lin","doi":"10.1016/j.rmed.2025.108181","DOIUrl":"10.1016/j.rmed.2025.108181","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a common respiratory disease associated with several comorbidities. Although chronic kidney disease (CKD) has been recognized as one such comorbidity, the effect of CKD on survival in patients with COPD remains uncertain. This study investigated the clinical impact of CKD in patients with COPD, accounting for clinically characteristics and 6-min walking test (6MWT) results.</div></div><div><h3>Materials and methods</h3><div>Patients with COPD who completed the 6MWT and a 3-year follow-up were retroactively enrolled in the study. Data on clinical information, 6MWT parameters, and outcomes were collected and analyzed.</div></div><div><h3>Results</h3><div>Among the 141 patients with COPD enrolled, 33 (23.4 %) had comorbid CKD. Patients with CKD were significantly older and more likely to experience heart failure, mortality, and FEV1 decline than patients without CKD. Multivariate analysis revealed that 6-min walking distance &lt;350 m (odds ratio [OR]: 3.65, 95 % confidence interval [CI]: 1.05–12.06, <em>p</em> = 0.041) and CKD (OR: 4.66, 95 % CI: 1.30–16.76, <em>p</em> = 0.018) were independent risk factors for mortality.</div></div><div><h3>Conclusions</h3><div>Comorbid CKD was associated with an increased mortality rate and rapid FEV1 decline in patients with COPD. Patients with COPD and comorbid CKD may require intensive monitoring during treatment.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108181"},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168190","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":"Bronchiectasis: A clinical review of inflammation","authors":"George Doumat ,&nbsp;Timothy R. Aksamit ,&nbsp;Amjad N. Kanj","doi":"10.1016/j.rmed.2025.108179","DOIUrl":"10.1016/j.rmed.2025.108179","url":null,"abstract":"<div><div>Bronchiectasis is a chronic inflammatory airway disease characterized by a self-perpetuating vortex of impaired mucociliary clearance, persistent infection, and progressive structural lung damage. While inflammation is central to disease activity and progression, targeted anti-inflammatory treatments have been limited. Understanding the different types of inflammation involved and their significant overlap is essential for effective management. This review explores key inflammation patterns, biomarkers, and available treatments across the spectrum of inflammation in bronchiectasis, with a particular focus on non-cystic fibrosis bronchiectasis in adults. Neutrophilic inflammation remains the hallmark of bronchiectasis, with promising reversible dipeptidyl peptidase-1 inhibitors reducing the activation of neutrophil serine proteases during neutrophil maturation. Eosinophilic inflammation has also gained attention, with evidence indicating that patients with this endotype may benefit from glucocorticoids and biologic therapies targeting type 2 inflammation. Additional inflammatory mechanisms discussed here include impaired epithelial function and mucociliary abnormalities, immune dysregulation, and airway inflammation triggered by infections, environmental irritants, and autoimmune conditions. Written for general clinicians, this review simplifies complex concepts, underscores key aspects of diagnostic evaluation, and discusses both conventional and emerging treatments for bronchiectasis, providing practical insights for improved personalized patient care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108179"},"PeriodicalIF":3.5,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147104","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":"Chronic obstructive pulmonary disease is associated with a higher incidence of acute kidney injury in non-cardiac but not in cardiac surgery ICU-patients: a retrospective MIMIC-III database analysis","authors":"Nadine Hochhausen ,&nbsp;Ajay Moza ,&nbsp;Andreas Kroh ,&nbsp;Rolf Rossaint ,&nbsp;Felix Kork","doi":"10.1016/j.rmed.2025.108160","DOIUrl":"10.1016/j.rmed.2025.108160","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute kidney injury (AKI) and chronic obstructive pulmonary disease (COPD) are both associated with high mortality. We hypothesized that COPD impacts the incidence of AKI and the outcome of surgical intensive care unit (ICU)-patients.</div></div><div><h3>Materials and methods</h3><div>We analyzed data of surgical ICU-patients from the Medical-Information-Mart-for-Intensive-Care-III-database. We compared the incidence of AKI, in-hospital-mortality, ICU-and hospital-length-of-stay (ICU-LOS, HLOS) in patients with and without COPD. In a subgroup analysis, we compared the outcomes of patients undergoing cardiac (CS) and non-cardiac surgery (NCS).</div></div><div><h3>Results</h3><div>The data of 21,720 cases were analyzed, 9.7 % suffered from COPD. COPD-patients were younger compared to patients without COPD (64years(52–75)vs.71years(63–78),p &lt; 0.001). Males were more frequently represented in both groups (58.3 %vs.61.2 %,p = 0.009). COPD-patients had a higher incidence of AKI (24.2 %vs.19.7 %,p &lt; 0.001), higher in-hospital-mortality (8.7 % vs.6.4 %,p &lt; 0.001), longer ICU-LOS (3.1days(IQR,1.6–7.0)vs.2.3days(IQR,1.3–5.0),p &lt; 0.001), and HLOS (10days(IQR,6–17)vs.8days(IQR,5–15),p &lt; 0.001). Multivariable analyses could not confirm a higher risk for AKI in surgical COPD-patients but for all other outcomes (in-hospital mortality,OR:1.59,95 %CI:1.24–2.04,p &lt; 0.001; ICU-LOS,beta:1.1, 95 %CI:0.6–2.3,p &lt; 0.001; HLOS,beta:1.7,95 %CI:0.9–2.4,p &lt; 0.001).</div><div>Subgroup analyses revealed that COPD was associated with a higher risk of AKI (OR,1.24,95 %CI:1.01–1.51,p = 0.038), longer ICU-LOS (beta:0.9,95 %CI:0.3–1.5,p = 0.006) and HLOS (beta:1.4,95 %CI:0.2–2.5,p = 0.018) but not with a higher risk for in-hospital mortality in NCS-patients. In CS-patients on the other hand, COPD was associated with a higher risk for in-hospital mortality (OR,1.73,95 %CI:1.02–2.94,p = 0.043) but neither for AKI, longer ICU-LOS or HLOS.</div></div><div><h3>Conclusions</h3><div>COPD has a different impact on outcomes in CS- and NCS-patients. While COPD was associated with a higher risk for in-hospital mortality in CS-patients, COPD was associated with a higher risk of AKI, longer ICU-LOS and HLOS in NCS-patients.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108160"},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151548","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":"Individual factors affecting oxygen saturation under acute hypoxia exposure in air personnel","authors":"Idan Nakdimon ,&nbsp;Daniela Algranati ,&nbsp;Asaf Glass ,&nbsp;Anna Levkovsky ,&nbsp;Uri Eliyahu ,&nbsp;Oded Ben-Ari ,&nbsp;Barak Gordon","doi":"10.1016/j.rmed.2025.108175","DOIUrl":"10.1016/j.rmed.2025.108175","url":null,"abstract":"<div><div>During flight, cabin pressure failure or oxygen system malfunction may lead to an oxygen-deprived environment, which could lead to a physiological state of hypoxia. Personal tolerance will determine cognitive performance level under these conditions. The aim of this study was to examine the influence of different parameters on hypoxia tolerance. As cognitive function was previously found to be associated with oxygen saturation levels (SatO₂), hypoxia tolerance was assessed using this method. A linear mixed models analysis revealed a significant correlation between decreased SatO₂ and BMI, hemoglobin levels, smoking, FEV1/FVC ratio, and age. In a further analysis, higher SatO₂ levels were significantly and independently associated in smokers (p = 0.012) and trainees with BMI above 27.7 kg/m² (p = 0.025 to 0.032). Moreover, non-smoking trainees with hemoglobin value above 15.9 g/dL (p = 0.016), and non-smoking trainees with FEV1/FVC ratio below 0.78 (p = 0.040 to 0.049) were correlated with significantly higher SatO₂. In this analysis, age, sex, and physical activity were not found to be correlated with SatO₂. Higher SatO₂ levels are correlated with higher hypoxia tolerance, hence the aforementioned parameters increase hypoxia tolerance. It is recommended to take these parameters into consideration during dedicated hypoxia trainings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108175"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139383","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}