Respiratory medicine最新文献

{"title":"Association of circadian syndrome and lung health: A population-based cohort study","authors":"Shuwen Zhang ,&nbsp;Jiangtao Lin","doi":"10.1016/j.rmed.2025.108031","DOIUrl":"10.1016/j.rmed.2025.108031","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have explored the association between circadian syndrome (CircS) and lung health.</div></div><div><h3>Objective</h3><div>To assess the relationship between CircS and lung health.</div></div><div><h3>Methods</h3><div>This prospective cohort study enrolled 6252 adults. Multivariable logistic and linear regression models were employed to examine the association between CircS and the prevalence of chronic lung disease, respiratory symptoms, and lung function, as appropriate. Receiver operating characteristic curve analysis was used to compare the predictive power of the number of metabolic syndrome (MetS) and CircS components for lung health. Kaplan-Meier survival and multiple Cox regression analyses were used to assess the relationship between CircS and all-cause mortality. The effects of CircS on health-related quality of life (HQL) and health care use were also evaluated.</div></div><div><h3>Results</h3><div>Participants with CircS were significantly associated with a higher prevalence of asthma, chronic bronchitis, cough, wheeze, phlegm production, and exertional dyspnea. The number of CircS components demonstrated better predictive power for the prevalence of asthma, chronic bronchitis, emphysema, cough, wheeze, phlegm production, and exertional dyspnea than the number of MetS components. Higher numbers of CircS components were significantly associated with decreased forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC), worse HQL, and increased health care use. Longitudinally, participants with CircS exhibited a higher risk of all-cause mortality than those without CircS.</div></div><div><h3>Conclusions</h3><div>Our results support the claim of that CircS is a better predictor of lung health than the MetS in adults in the United States. Elevated CircS levels are associated with poorer lung function, increased health care use, worse HQL, and a higher risk of mortality.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108031"},"PeriodicalIF":3.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586760","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":"Association of once-daily single-device dual bronchodilators with prevention of rehospitalization for chronic obstructive pulmonary disease: A retrospective national inpatient database study","authors":"Shosei Ro ,&nbsp;Shotaro Aso ,&nbsp;Hiroki Matsui ,&nbsp;Kiyohide Fushimi ,&nbsp;Hideo Yasunaga","doi":"10.1016/j.rmed.2025.108033","DOIUrl":"10.1016/j.rmed.2025.108033","url":null,"abstract":"<div><h3>Background</h3><div>Optimal fixed-dose combination (FDC) dual bronchodilators for chronic obstructive pulmonary disease (COPD) are yet to be identified. We aimed to compare outcomes between two types of optimal once-daily FDC dual bronchodilators delivered by a dry powder inhaler (DPI) and soft mist inhaler (SMI).</div></div><div><h3>Methods</h3><div>Using the Japanese Diagnosis Procedure Combination database, we identified patients with COPD, aged ≥40 years, who were prescribed DPIs or SMIs at discharge from 2015 to 2021. Patients who were prescribed inhaled corticosteroids were excluded. We used inverse probability of treatment weighting (IPTW) to compare COPD-related rehospitalization, outpatient prescription of antibiotics and oral corticosteroids, and cardiovascular event-related rehospitalization between the DPI and SMI groups.</div></div><div><h3>Results</h3><div>Among 31,145 eligible patients, 18,359 patients were prescribed DPIs, and 12,786, SMIs. After IPTW, there were no differences in the proportions of patients with COPD-related rehospitalization (25.4 % vs. 24.7 %; P = 0.379) or outpatient prescription of antibiotics and oral corticosteroids (7.8 % vs. 7.8 %; P = 0.819) between the groups. The proportion of patients with cardiovascular event-related rehospitalizations was significantly smaller in the DPI group than in the SMI group (4.3 % vs. 5.2 %; P = 0.004). Subgroup analyses showed fewer COPD-related rehospitalizations among patients with Hugh-Jones classification 4–5 in the SMI group than in the DPI group (−2.1 %; 95 % confidence interval: −4.0 % to −0.3 %).</div></div><div><h3>Conclusion</h3><div>No significant difference was found in preventing COPD-related rehospitalization between DPI and SMI use. However, DPI use was associated with fewer cardiovascular event-related rehospitalizations than SMI use. SMI use may be effective in patients with severe dyspnoea.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108033"},"PeriodicalIF":3.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586762","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":"Analysis of research trends and hot spots on COPD biomarkers from the perspective of bibliometrics","authors":"Ying Liu ,&nbsp;Jianliang Huang ,&nbsp;Enping Li ,&nbsp;Yun Xiao ,&nbsp;Chengyou Li ,&nbsp;Mingkai Xia ,&nbsp;Jun Ke ,&nbsp;Lijun Xiang ,&nbsp;Mingsheng Lei","doi":"10.1016/j.rmed.2025.108030","DOIUrl":"10.1016/j.rmed.2025.108030","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD), a chronic respiratory condition with airflow limitation, is the fourth leading global cause of death. Biomarkers are key for classifying COPD, detecting exacerbations, guiding treatment, and prognosis. This article uses bibliometrics and visualization to analyze COPD biomarker research trends, providing insights for future studies.</div></div><div><h3>Methods</h3><div>This study adopts a range of literature analysis tools, including HistCite, VOSviewer, and CiteSpace, to systematically analyze literature on COPD biomarkers within the Web of Science Core Collection database from 2005 to 2024.</div></div><div><h3>Results</h3><div>A total of 1835 papers or reviews related to COPD biomarkers are included in this study. Since 2003, the number of publications in this field has been on an upward trajectory. The United States being most influential in this field (n = 415, TLCS = 2319). Prominent institutions such as the University of British Columbia consistently deliver high-quality research results. Tal-Singer R, Sin DD, and Vestbo J have made significant contributions to COPD biomarker research. The journal American Journal of Respiratory and Critical Care Medicine is the most authoritative choice for researchers in the field.This research has long focused on biomarkers associated with the inflammatory response (C-reactive protein, eosinophils, etc.), pulmonary function, induced sputum, and computed tomography. Looking ahead, biomarkers such as microRNA, exosomes, DNA methylation, and microbiomics are likely to become popular topics, particularly regarding their roles in the prognosis and mechanisms of COPD.</div></div><div><h3>Conclusion</h3><div>Bibliometric analysis suggests that future research on COPD biomarkers will focus on advanced fields, such as microRNA, exosomes, DNA methylation, and microbiomics.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108030"},"PeriodicalIF":3.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586758","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":"Asthma outcomes in a safety net hospital system: A comparative study to a national cohort","authors":"Juan Ortiz ,&nbsp;Kristen A. Staggers ,&nbsp;Muhammad Adrish ,&nbsp;Nicola A. Hanania ,&nbsp;Tianshi David Wu","doi":"10.1016/j.rmed.2025.108032","DOIUrl":"10.1016/j.rmed.2025.108032","url":null,"abstract":"<div><h3>Background</h3><div>Asthma disproportionately affects vulnerable populations. Safety net hospitals (SNHs) manage a significant proportion of these patients. Despite the assumption that patients in SNHs have more severe asthma, little is known about how their outcomes compare to the general population.</div></div><div><h3>Methods</h3><div>Asthma patients from Harris Health System (HHS), a large SNH system in Texas, were compared to a representative national cohort of patients from Epic Cosmos (EC), a US-wide aggregated electronic health record database. Asthma was defined by ≥ 2 outpatient diagnoses and prescription for asthma medications from 2021 to 2022. Demographics, comorbidities, and asthma outcomes were analyzed. Comparisons between groups were made using standardized mean differences (SMD). Logistic regression was used to standardize exacerbation rates.</div></div><div><h3>Results</h3><div>We identified 2644 HHS and 602,460 EC patients. HHS patients were more likely to identify as Hispanic (55.7 % vs. 7.6 %) and non-White (79.4 % vs. 30.2 %) and had higher rates of obesity and metabolic comorbidities. Despite more intensive asthma medication use and a higher proportion with elevated blood eosinophils and serum IgE, patients with asthma treated within HHS had a similar prevalence of severe asthma exacerbations as compared to EC (28.0 % vs. 27.5 %), which was not statistically different (SMD = 0.01). Direct standardization to EC showed a numerically but not statistically lower rate of exacerbations among patients seen at HHS (24.3 % vs 27.5 %).</div></div><div><h3>Conclusions</h3><div>Patients treated at a large SNH had comparable asthma outcomes to the general asthma population. These findings emphasize the critical role of resourcing SNHs to improve asthma management and reduce health disparities.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108032"},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586764","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":"Schistosomiasis-associated pulmonary arterial hypertension (Sch-PAH): A comprehensive review of diagnosis and management","authors":"Ramakanth Pata ,&nbsp;Bhanu Kosuru ,&nbsp;Joanna Kristeva","doi":"10.1016/j.rmed.2025.108026","DOIUrl":"10.1016/j.rmed.2025.108026","url":null,"abstract":"<div><div>Schistosomiasis is the second most dangerous parasitic disease, affecting approximately 200 million people worldwide. Chronic Schistosomiasis, especially the hepatosplenic form, can lead to the development of pulmonary arterial hypertension and has been classified as a distinct entity referred to as “Schistosomiasis-associated pulmonary arterial hypertension” (Sch-PAH). Several mechanisms may play a role in the pathogenesis of Sch-PAH, which include peri-ovular granulomatous inflammation with subsequent vascular remodeling. Pro-inflammatory and pro-fibrotic cytokines with altered downstream signaling of bone morphogenic protein receptor 2 pathway (BMRP-2) have been hypothesized based on the mouse models. Diagnosis of Sch-PAH requires confirmation of pre-capillary pulmonary arterial hypertension by right heart catheter and further evaluation of etiology in those with risk factors for schistosomiasis with anti-schistosomal antibody levels. Although there is no robust evidence to suggest a specific management of Sch-PAH, Phosphodiesterase −5 inhibitors (PDE-i) have been shown to improve functional capacity, 6-min walk test, and an improvement in cardiac index. There is some evidence that treatment of underlying infection, if never been considered may have some benefit in the management of Sch-PAH.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108026"},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578297","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":"Evaluation of the benefits of respirator breathing and vomiting training and dynamic core training on improving respiratory muscle strength","authors":"Ran He ,&nbsp;Lin Ren","doi":"10.1016/j.rmed.2025.108029","DOIUrl":"10.1016/j.rmed.2025.108029","url":null,"abstract":"<div><h3>Background and objective</h3><div>Respiratory muscle training is a widely used method in clinical diagnosis and medical treatment. Due to the fact that the respiratory muscles are located in the core area that supports the human body. Therefore, understanding how to train the core muscle group in the correct way is of great significance in improving physical fitness and reducing the occurrence of sports injuries.</div></div><div><h3>Methods</h3><div>This article reviews the effects of respirator breathing and vomiting training (RBVT) and dynamic core training on respiratory muscle strength and related physiological mechanisms.</div></div><div><h3>Results</h3><div>Both acute and long-term RBVT can promote respiratory muscle function, thereby reducing or delaying the degree of respiratory muscle fatigue, and helping to accelerate the clearance of lactate after exercise. The intra-abdominal pressure generated by dynamic core resistance training can stimulate the diaphragm, reduce discomfort caused by professional equipment training, improve respiratory muscle function, and enhance athletic performance. Low intensity core training may improve the central nervous system's control of muscle coordination, thus benefiting from increased movement efficiency, while high-intensity core training may increase the strength of core muscle groups, thus benefiting athletes' athletic performance.</div></div><div><h3>Conclusion</h3><div>RBVT is not suitable for training the diaphragm, But dynamic core training can reduce discomfort caused by specialized equipment training. It can be used for rehabilitation, improve respiratory muscle function, and enhance exercise performance. However, the optimal diaphragm pressure generated by the transverse abdominal muscle and internal oblique muscle is a topic worthy of further research.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108029"},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586766","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":"Galectin-3 level in idiopathic pulmonary fibrosis patients and its relationship with response to antifibrotic treatment","authors":"Sibel Emre ,&nbsp;Nevin Fazlıoğlu ,&nbsp;Ersan Emre ,&nbsp;Levent Cem Mutlu ,&nbsp;Ahsen Yılmaz","doi":"10.1016/j.rmed.2025.108028","DOIUrl":"10.1016/j.rmed.2025.108028","url":null,"abstract":"<div><h3>Object</h3><div>Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease with characterized by progressive fibrosis. Galectin-3(Gal-3) is a B-galactoside binding lectin plays a central role in inflammation and fibrosis. In our study, we aimed to define levels of serum galectin-3 protein in IPF patients by comparing them with healthy subjects. We also aimed to show that galectin-3 concentrations can be used as a diagnostic and prognostic biomarker in the serum of IPF patients and that the use of galectin-3 inhibitors in combination with antifibrotic treatments may be useful in the therapeutic management of fibrosis.</div></div><div><h3>Methods</h3><div>44 patients with IPF and 35 control patients who were followed up in our outpatient clinic between 2016 and 2022 were evaluated, anamnesis, spirometric measurements and galectin-3 results were recorded. Patients were grouped according to their antifibrotic treatment.</div></div><div><h3>Results</h3><div>The mean galectin-3 level in the patient group was 8.4 ng/ml and in the control group was 8.2 ng/ml. Serum levels were 8.9 ng/ml in pirfenidone users and 8.2 ng/ml in nintedanib users. Gal-3 was found to be higher in patients taking pirfenidone compared to nintedanib, but there was no statistically significant difference (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Galectin-3 levels were found to be slightly higher in IPF patients compared to healthy subjects. In addition, gal-3 levels decreased as the follow-up period increased in IPF patients in our study. Considering that the patients were receiving pirfenidone or nintedanib treatment during the follow-up period, it may be possible that galectin-3 levels decreased as exposure to these drugs increased. Further studies are needed to clarify these mechanisms.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108028"},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573751","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":"Bacterial colonisation doubles the risk of exacerbation in alpha-1 antitrypsin deficiency","authors":"Daniella A. Spittle ,&nbsp;Anita Pye ,&nbsp;Jan Stanka ,&nbsp;Joshua De Soyza ,&nbsp;Robert A. Stockley ,&nbsp;Alice M. Turner","doi":"10.1016/j.rmed.2025.108025","DOIUrl":"10.1016/j.rmed.2025.108025","url":null,"abstract":"<div><div>Pulmonary exacerbations in alpha-1 antitrypsin deficiency (AATD) are associated with worse disease outcomes, including accelerated lung function decline. As with non-deficient COPD, subjects with AATD are predisposed to bacterial colonisation of the lower respiratory tract, a known risk factor for exacerbations. Despite this, the extent to which colonising bacteria contribute to exacerbations remains relatively unexplored.</div><div>Sputum samples were collected longitudinally from AATD subjects, when clinically stable and during exacerbations, and were processed for quantitative culture to identify bacterial pathogens. Using contemporaneous clinical data, a post-hoc analysis was performed to calculate the odds of an exacerbation in the presence of recognised, potentially pathogenic bacteria (PPB) of the lower respiratory tract.</div><div>324 sputum samples were collected from 29 patients with AATD plus radiological evidence of bronchiectasis and 671 samples from 62 patients without bronchiectasis (AATD alone). Both groups contained patients with AATD-associated lung disease (emphysema and chronic bronchitis). At least half of the samples (55.5 %) from AATD alone were positive for a PPB and almost three quarters (72.8 %) of those with bronchiectasis. Presence of a <em>Pseudomonas</em> species, <em>Staphylococcus aureus</em> or <em>Moraxella catarrhalis</em> during stable state disease were all significantly associated with increased likelihood of a subsequent exacerbation (OR: 1.89, p = 0.0013; 1.98, 0.0022; 1.98, 0.0047; 2.19, 0.0047, respectively), independent of age, sex, disease severity (FEV1 impairment), smoking status and presence or absence of bronchiectasis.</div><div>Disease progression in AATD is variable and identification of traits which may contribute may prove influential. Here, we report that bacterial colonisation is an important predictor of exacerbation in AATD, likely attributed to the associated levels of increased inflammation. Thereby, this may represent a sub cohort of patients that could benefit from additional, targeted therapy.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108025"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568047","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":"Reduction in circulating Endothelin-1 levels by inhaled COPD medications","authors":"Hiroki Sato ,&nbsp;Tatsuya Nagano ,&nbsp;Ratoe Suraya ,&nbsp;Daisuke Hazama ,&nbsp;Kanoko Umezawa ,&nbsp;Naoko Katsurada ,&nbsp;Masatsugu Yamamoto ,&nbsp;Motoko Tachihara ,&nbsp;Yoshihiro Nishimura ,&nbsp;Noriaki Emoto ,&nbsp;Kazuyuki Kobayashi","doi":"10.1016/j.rmed.2025.108027","DOIUrl":"10.1016/j.rmed.2025.108027","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) can be complicated by pulmonary hypertension (PH), impacting prognosis and quality of life. Endothelin-1 (ET-1) is implicated in PH development and elevated in COPD patients. The impact of COPD treatments on ET-1 and COPD-related PH remains unclear. This study investigated changes in ET-1 levels after administration of inhaled COPD medications and explored underlying mechanisms.</div></div><div><h3>Methods</h3><div>Patients underwent pulmonary function tests, COPD Assessment Test, and plasma ET-1 measurement before and 4–12 weeks after treatment initiation. In mice, elastase-induced emphysema was treated with budesonide (BUD), glycopyrronium (GLY), and formoterol (FOR) combinations for 2 weeks. Plasma ET-1 concentration and cytokine expression were analysed. HULEC-5a cells were used to examine ET-1 expression after TNFα stimulation.</div></div><div><h3>Results</h3><div>The study included 33 patients. COPD patients (n = 24) showed higher baseline plasma ET-1 levels compared to controls (n = 9) (2.12 pg/ml vs 1.54 pg/ml, p &lt; 0.001). Plasma ET-1 levels decreased in COPD patients posttreatment (2.12–1.82 pg/ml, p = 0.004), with reductions observed across all disease stages and treatment regimens.</div><div>Mice showed elevated ET-1 levels and expression of inflammatory cytokines after elastase instillation. BUD/GLY/FOR treatment significantly reduced ET-1 concentration and TNFα expression. Furthermore, TNFα stimulation upregulated ET-1 expression in HULEC-5a cells.</div></div><div><h3>Conclusions</h3><div>In COPD patients conventional treatment decreased ET-1 concentration. In mouse models TNFα expression was suppressed by BUD/GLY/FOR. In HULEC-5a cells, TNFα stimulation exerted an increased ET-1expression. These findings suggest that the suppressive effect of inhaler therapy on ET-1 expression is due to the anti-inflammatory effects of these drugs.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108027"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561918","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":"Asthma exacerbation comorbidity index (AECI): Predicting in-hospital adverse outcomes","authors":"Chongyang Zhao ,&nbsp;Lei Wang ,&nbsp;Li Zhang ,&nbsp;Qin Wang ,&nbsp;Li Li ,&nbsp;Ying Liu ,&nbsp;Lei Liu ,&nbsp;Lishan Yuan ,&nbsp;Min Feng ,&nbsp;Gang Wang ,&nbsp;Shuwen Zhang ,&nbsp;Yulai Yuan ,&nbsp;Deying Kang ,&nbsp;Xin Zhang","doi":"10.1016/j.rmed.2025.108024","DOIUrl":"10.1016/j.rmed.2025.108024","url":null,"abstract":"<div><h3>Background</h3><div>Despite optimal treatment, asthma exacerbations (AEs) can lead to severe adverse events, including mortality. Effective management of comorbidities is critical, as they are common in asthma patients and significantly impact quality of life, healthcare use, and treatment outcomes. Currently, no comprehensive clinical tool exists for assessing and managing these comorbidities during AE.</div></div><div><h3>Methods</h3><div>We conducted a real-world study involving inpatients with AE. We assessed the risk of in-hospital composite outcome including death, intensive care unit admission, or invasive ventilation, associated with individual comorbidities, comorbidity systems, and the total number of comorbidities. We developed a predictive tool, the Asthma Exacerbation Comorbidity Index (AECI), which incorporates the major comorbidities identified. Patients were categorized into three risk groups based on their AECI scores.</div></div><div><h3>Results</h3><div>Among the 43 comorbidities assessed, nine were significantly associated with the composite outcome. Each additional comorbidity increased the risk of the composite outcome by 25% (95% CI, 16.5%–34.1%; P &lt; 0.001). The most prevalent comorbidity systems were the endocrine (51.7%), respiratory (50.9%), and cardiovascular (43.3%) systems, with 54.1% of patients exhibiting multiple comorbidity systems. The AECI exhibited an area under the curve (AUC) of 75.98%. A one-point increase in the AECI was associated with a 0.51-fold increase in the risk of composite outcome (95% CI, 0.41–0.62; P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The high prevalence of comorbidities among patients with AEs is associated with a poorer prognosis. The AECI proves to be a valuable tool to assess comorbidities, enabling clinicians to identify inpatients at higher risk of adverse in-hospital events and to make informed treatment decisions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"240 ","pages":"Article 108024"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561919","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}