Respiratory medicine最新文献

{"title":"Correlation between obstructive sleep apnea and pituitary function in pituitary adenomas patients","authors":"Zitong Wang ,&nbsp;Qi Li ,&nbsp;Junjie Zhao ,&nbsp;Hai Yu ,&nbsp;Jiayi Du ,&nbsp;Tingqin Huang ,&nbsp;Yushan Xie ,&nbsp;Zine Cao ,&nbsp;Chendi Lu ,&nbsp;Xinru Lv ,&nbsp;Simin Zhu ,&nbsp;Yanuo Zhou ,&nbsp;Wei Hou ,&nbsp;Yani Feng ,&nbsp;Haiqin Liu ,&nbsp;Xiaoyong Ren ,&nbsp;Yewen Shi","doi":"10.1016/j.rmed.2026.108660","DOIUrl":"10.1016/j.rmed.2026.108660","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to analyze the correlation between pituitary function and obstructive sleep apnea (OSA) in pituitary adenomas (PA) patients, and to investigate the effect of related hormone levels on the severity of OSA.</div></div><div><h3>Methods</h3><div>The clinical data of 82 patients with PA aged 18–70 years admitted to the Department of Neurosurgery, Xi'an Jiaotong University Affiliated Hospital from March 2023 to February 2025 were retrospectively collected and divided into functional and non-functional PA group.</div></div><div><h3>Results</h3><div>Functional PA patients were younger and had a higher platelet-lymphocyte ratio (all <em>p</em> &lt; 0.05). Among the PSG related parameters, Patients with functional PA showed higher apnea-hypopnea index (AHI), total sleep time spent with arterial oxygen saturation&lt;90 % and longest apnea duration and oxygen desaturation index with &gt;3 % desaturation (all <em>p</em> &lt; 0.01). In terms of pituitary function parameters, free triiodothyronine (FT3) and insulin-like growth factor-1 (IGF-1) were significantly increased in OSA group, while the levels of cortisol, estradiol and progesterone were all lower (all <em>p</em> &lt; 0.05). Correlation analysis showed that AHI was positively correlated with FT3 and IGF-1. After adjusting for confounding factors, mediation analysis based on regression revealed that FT3 and IGF-1 mediated the association between PA and OSA severity.</div></div><div><h3>Conclusion</h3><div>OSA was more severe in functional PA patients compared with non-functional PA patients. FT3 and IGF-1 are reliable predictors of AHI in PA patients, and may become important indicators for early clinical diagnosis of OSA in PA patients. Larger prospective studies are needed to further clarify the relationship between PA and OSA in the future.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108660"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023126","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":"Correlation of S100A8/A9 and AKT/NF-κB expression with severity and prognosis of type 2 diabetes mellitus complicated with severe pneumonia","authors":"Xiuyi Zhu ,&nbsp;Shibo Wei ,&nbsp;Aihong Chen ,&nbsp;Qunqiong Zhong","doi":"10.1016/j.rmed.2026.108650","DOIUrl":"10.1016/j.rmed.2026.108650","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the correlation between S100A8/A9, protein kinase B (AKT)/nuclear transcription factor κB (NF-κB) expression and the severity/prognosis of type 2 diabetes mellitus (T2DM) complicated with severe pneumonia, and provide a reference for improving clinical prognosis.</div></div><div><h3>Methods</h3><div>A total of 130 T2DM patients with severe pneumonia (study group) and 65 non-T2DM patients with severe pneumonia (control group) were enrolled. S100A8/A9 (protein) and AKT/NF-κB (mRNA) levels were compared. The study group was subdivided into mild (43 cases), moderate (55 cases), and severe (32 cases) subgroups based on APACHE II scores. Spearman correlation, receiver operating characteristic (ROC) curve, and relative risk (RR) were used to analyze correlation with severity, prognostic value, and prognosis-related risk, respectively.</div></div><div><h3>Results</h3><div>Molecular levels in the study group were higher than those in the control group (P &lt; 0.05), increased with disease severity (mild &lt; moderate &lt; severe, P &lt; 0.05) and were positively correlated with severity (all P &lt; 0.05). Levels were lower in the good prognosis group than in the poor prognosis group (P &lt; 0.05). The combined ROC AUC for prognosis was 0.919 (95 %CI: 0.859–0.960), exceeding that of individual markers (P &lt; 0.05). High expression of each molecule was associated with a significantly increased risk of poor prognosis (RRs: 5.210, 3.771, 5.579, 4.105, respectively; all P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>S100A8/A9 and AKT/NF-κB expression is closely related to the severity of T2DM complicated with severe pneumonia and holds prognostic value, with high expression indicating a higher risk of poor prognosis.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108650"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978082","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":"Google Trends as a health sentinel. ALERT study: Analyzing Symptoms Perceptions Related To Environmental pollution","authors":"Benedetta Bondi ,&nbsp;Fulvio Braido ,&nbsp;Ilaria Baiardini ,&nbsp;Federico Di Marco ,&nbsp;Carola Montagnino ,&nbsp;Martina Buscema ,&nbsp;Cesare de Tommaso ,&nbsp;Filippo Tarchino ,&nbsp;Marcello Mincarini ,&nbsp;Anna Maria Riccio ,&nbsp;Diego Bagnasco","doi":"10.1016/j.rmed.2025.108623","DOIUrl":"10.1016/j.rmed.2025.108623","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between environmental pollution and human health is well-documented, and exposure has been linked to an increased risk of respiratory and psychological diseases. In our clinical practice, a trend of self-medication and self-diagnosis has emerged, defined as independent web searches for self-reported symptoms aimed at obtaining a diagnosis and related treatment in the absence of medical advice.</div></div><div><h3>Objective</h3><div>This study aims to investigate the relationship between air pollution and public health, focusing on the impact of particulate matter (PM 2.5, PM 10), nitrogen dioxide (NO2), ozone (O3), and other pollutants on respiratory and mental health, and their relationship with web searches for health-related topics.</div></div><div><h3>Methods</h3><div>The study compares search trends for specific terms (e.g., cough, dyspnea, asthma, etc.), obtained using Google Trends, a tool for assessing public interest in health-related issues, with air main pollutants concentrations collected over the same period in 2024 in Genoa, Liguria region.</div></div><div><h3>Results</h3><div>Correlation between searches for cough and levels of PM 2.5, O3, benzene, and NO2 was established, while depression also showed a connection to PM 2.5 and benzene.</div></div><div><h3>Discussion</h3><div>These findings underscore the potential of Google Trends as a valuable resource for epidemiological surveillance. The study highlights the necessity for healthcare systems to adapt to the implications of air quality on health outcomes. It emphasizes the need for innovative approaches, including real-time tracking of air pollution and its health impacts, to enhance patient care and inform clinical practice. The integration of technology and data analytics in healthcare is proposed as a forward-looking strategy to improve therapeutic adherence and patient management in the context of environmental health challenges.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108623"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878863","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":"High-dimensional single-cell analysis evaluating effects of different airway management strategies on perioperative immune cells in non-small cell lung cancer surgery","authors":"Jinbo Tang ,&nbsp;Sipei Wu ,&nbsp;Lin He ,&nbsp;Qiangwei Huang ,&nbsp;Hongyang Li ,&nbsp;Lin Yu ,&nbsp;Qingqing Yang ,&nbsp;Puyi Lie ,&nbsp;Dakai Xiao ,&nbsp;Jianxing He ,&nbsp;Yuan Qiu ,&nbsp;Wenjun Wang","doi":"10.1016/j.rmed.2025.108585","DOIUrl":"10.1016/j.rmed.2025.108585","url":null,"abstract":"<div><div>This study investigates the effects of different airway management strategies on perioperative immune cells in patients undergoing non-small cell lung cancer (NSCLC) surgery. A total of 23 patients were enrolled and randomly assigned to either the endotracheal intubation (ETT) group or the supraglottic airway device (SAD) group. Comprehensive mass cytometry analysis was performed on peripheral blood CD45⁺ cells to evaluate immune cell populations. The SAD group demonstrated significantly reduced consumption of neuromuscular blocking agents and opioid requirements compared to the ETT group, with comparable surgical parameters. Notably, the SAD group showed favorable trends in clinical recovery metrics such as analgesic requirements. The study highlights the impact of airway management techniques on immune function, suggesting that the SAD approach may better preserve immune cell populations during surgery. These findings contribute to understanding the early perioperative immune response in NSCLC patients and may inform clinical practices in anesthesia management.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108585"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782733","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":"Limited clinical utility of annual chest radiographs in adults with cystic fibrosis: A 10-year observational study from a UK centre","authors":"Hasti Robbie ,&nbsp;Aditya Sharma ,&nbsp;Cheng Fang ,&nbsp;Christopher Stovin ,&nbsp;Joe Bedford ,&nbsp;Sam Norton ,&nbsp;Michael D. Waller","doi":"10.1016/j.rmed.2025.108611","DOIUrl":"10.1016/j.rmed.2025.108611","url":null,"abstract":"<div><h3>Background</h3><div>In the United Kingdom, annual chest radiography is recommended to monitor disease progression in people with cystic fibrosis (CF), yet robust evidence for its utility or relationship with clinical outcomes is lacking. This study explores disease progression on serial chest radiographs, together with relationships of other markers of disease severity.</div></div><div><h3>Method</h3><div>Single centre, retrospective analysis of annual chest radiographs in adults with CF across ≥10 years. A novel chest x-ray (CXR) scoring system was developed, and annual chest radiographs scored, along with time-matched spirometry and body mass index.</div></div><div><h3>Results</h3><div>28 patients, aged 33.0 (31.0–39.5) years were included. Mean follow-ups were 11.4 (SD = 1.9) years with a total of 304 CXR scored (mean = 10.9/person). Overall inter-observer agreement was good. No significant or only weak associations were found between changes in total CXR score, or individual CXR variables, and changes in any clinical parameter.</div></div><div><h3>Conclusions</h3><div>Our new and practical CXR score shows annual changes in CXR in adults with CF are insufficiently sensitive to detect disease progression and show no relationship to changes in other clinical parameters. These data suggest limited value in routine annual CXR for stable adults with CF.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108611"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844127","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":"Sex differences in low arousal threshold in obstructive sleep apnea","authors":"Gloria Maria Citton ,&nbsp;Caterina Antonaglia ,&nbsp;Antonio Fabozzi ,&nbsp;Alessia Steffanina ,&nbsp;Silvia Giannone ,&nbsp;Mattia Manna ,&nbsp;Giulia Prezioso ,&nbsp;Chiara Torregiani ,&nbsp;Paola Confalonieri ,&nbsp;Francesco Salton ,&nbsp;Barbara Ruaro ,&nbsp;Paolo Palange ,&nbsp;Marco Confalonieri","doi":"10.1016/j.rmed.2025.108625","DOIUrl":"10.1016/j.rmed.2025.108625","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive Sleep Apnea Syndrome (OSAS) is the most common sleep-related breathing disorder, considered more prevalent in males. Recent evidences suggest that prevalence of OSAS in females is underestimated, with a clinical phenotype marked by sleep fragmentation, poor sleep quality, and neurobehavioral symptoms. We hypothesized that a low arousal threshold (low AT) may be more common in females, which may underline these clinical and polysomnographic differences.</div></div><div><h3>Methods</h3><div>In this retrospective multicentric study, 84 females and 93 males with OSA underwent a Home Sleep Apnea Test (HSAT) reviewed by a sleep expert. Low AT was predicted using the Edwards score criteria.</div></div><div><h3>Results</h3><div>Out of 177 patients, low AT was identified in 60.7 % of females and 40.9 % of males (p = 0.008). Stratifying by OSA severity, low AT was more prevalent in patients with mild disease, both in females and males. Among obese patients (Body Mass Index, BMI ≥30 kg/m²), low AT was present in 60.9 % of females compared to 24.3 % of males (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that a low AT is significantly more prevalent in OSA females, remembering that our female population mainly corresponds to post-menopausal females. This may explain the more pronounced sleep fragmentation and neurobehavioral symptoms in women.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108625"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893273","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":"High-flow nasal cannula versus CPAP for the prevention of bronchopulmonary dysplasia in preterm infants: a systematic review with meta-analysis and trial sequential analysis","authors":"Janneth Milena Avendaño-Vanegas ,&nbsp;Henry Mauricio Parada-Gereda ,&nbsp;Luis Alexander Peña-López ,&nbsp;Leonardo Arzayus-Patiño","doi":"10.1016/j.rmed.2026.108651","DOIUrl":"10.1016/j.rmed.2026.108651","url":null,"abstract":"<div><h3>Background</h3><div>Bronchopulmonary dysplasia (BPD) is common in preterm infants and is associated with invasive ventilation and prolonged oxygen therapy. Continuous positive airway pressure (CPAP) has been the standard non-invasive respiratory support for decades, but it may cause nasal trauma and poor tolerance. High-flow nasal cannula (HFNC) could improve comfort; however, its effectiveness in preventing BPD remains unconfirmed, and the available evidence is heterogeneous.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis with trial sequential analysis (TSA) of randomised controlled trials comparing HFNC with CPAP for the prevention of BPD in preterm infants. Searches were performed in PubMed, Scopus, Cochrane Library, LILACS, and Science Direct up to June 2025, with no language restrictions. The primary outcome was the incidence of BPD; secondary outcomes included air leak and nasal injury. Methodological quality was assessed using the Cochrane RoB 2.0 tool, certainty of evidence with GRADE, and publication bias with funnel plots and Egger's and Begg's tests. The protocol was registered in PROSPERO (CRD420251076520).</div></div><div><h3>Results</h3><div>Twenty trials were included (n = 2871 preterm infants). No significant differences were found in the incidence of BPD between HFNC and CPAP (RR: 0.86; 95 % CI: 0.73–1.02; p = 0.08; I² = 0 %). Similarly, no differences were observed for air leak (RR: 0.76; 95 % CI: 0.45–1.27; p = 0.29). However, HFNC significantly reduced the risk of nasal injury (RR: 0.40; 95 % CI: 0.33–0.49; p &lt; 0.00001). TSA indicated insufficient evidence to confirm a 20 % reduction in BPD. Most studies were at low risk of bias; certainty of the evidence was rated as low for BPD and air leak, and high for nasal injury.</div></div><div><h3>Conclusions</h3><div>HFNC showed no significant differences compared with CPAP in preventing BPD or air leak in preterm infants, although it reduced the risk of nasal injury. TSA suggests that current evidence is insufficient to confirm or refute a 20 % relative risk reduction in BPD, highlighting the need for further high-quality trials to establish definitive conclusions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108651"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023214","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":"High PEEP in perioperative vs. hypoxemic respiratory failure: Lessons from recent trials","authors":"Lei Gu ,&nbsp;Jian Yue ,&nbsp;Yuxuan Chen ,&nbsp;Wei Liu ,&nbsp;Jing Lin","doi":"10.1016/j.rmed.2026.108659","DOIUrl":"10.1016/j.rmed.2026.108659","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108659"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994491","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":"A novel respiratory reactance index, frequency-dependent, and for effort-independent assessment of COPD severity using MostGraph","authors":"Hiroyuki Tsuji ,&nbsp;Sho Mitsuya ,&nbsp;Kenjiro Tsuruoka ,&nbsp;Takahiko Nakamura ,&nbsp;Yosuke Tamura ,&nbsp;Isao Goto ,&nbsp;KyongYob Min ,&nbsp;Soichiro Ikeda ,&nbsp;Akihisa Imagawa ,&nbsp;Yasuhito Fujisaka","doi":"10.1016/j.rmed.2026.108656","DOIUrl":"10.1016/j.rmed.2026.108656","url":null,"abstract":"<div><h3>Background</h3><div>Oscillometry has gained attention as a respiratory function test that does not require patient effort, particularly in older individuals and in those with severe respiratory disease. Although spirometry is essential for classifying the severity of chronic obstructive pulmonary disease (COPD), it requires forced expiration, which may be difficult in frail patients. In COPD, the slope of the respiratory reactance curve measured by oscillometry changes. This study evaluated the usefulness of a novel index, [X5 × (Fres−5)]/ALX, which quantifies the frequency dependence of respiratory reactance using parameters measurable by oscillometry.</div></div><div><h3>Methods</h3><div>This retrospective observational study included patients with COPD who underwent spirometry and oscillometry at Osaka Medical and Pharmaceutical University Hospital between March 2014 and January 2020. X5, Fres, and ALX were measured using the MostGraph to calculate the novel index. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance for detecting Global Initiative for Obstructive Lung Disease (GOLD) stage 3/4 COPD, including sex-specific evaluations.</div></div><div><h3>Results</h3><div>Based on chest CT findings, patients with lung cancer or interstitial lung disease were excluded, leaving 109 participants. The novel index demonstrated strong performance in identifying GOLD stage 3/4 COPD (AUC: 0.858; sensitivity: 81.0 %; specificity: 79.5 %), outperforming X5, Fres, and ALX individually. The AUCs were 0.874 in males and 0.914 in females. The index showed a moderate correlation with %FEV1 (r_s = 0.603).</div></div><div><h3>Conclusion</h3><div>The index [X5 × (Fres−5)]/ALX effectively reflects the frequency dependence of respiratory reactance and may serve as a useful, effort-independent tool for assessing COPD severity, particularly for identifying GOLD stage 3/4 disease.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108656"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994530","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":"A prospective study of maintenance treatment for COPD patients hospitalised for severe exacerbations","authors":"Paul W. Jones ,&nbsp;Xiao Hu ,&nbsp;Fen Dong ,&nbsp;Ke Huang ,&nbsp;Tiantian Liu ,&nbsp;Tiantian Qi ,&nbsp;Tao Ye ,&nbsp;Yi Hu ,&nbsp;Jianrong Li ,&nbsp;Chen Wang ,&nbsp;Ting Yang","doi":"10.1016/j.rmed.2026.108648","DOIUrl":"10.1016/j.rmed.2026.108648","url":null,"abstract":"<div><h3>Purpose</h3><div>To quantify prescription of COPD maintenance treatment in patients hospitalised with an exacerbation.</div></div><div><h3>Patients and methods</h3><div>In this prospective study, COPD patients presenting in a stable state, or with an exacerbation, were recruited from 24 secondary and 15 tertiary care hospitals in China. This analysis concerns patients who were hospitalised. Maintenance treatment was recorded prior to admission, at discharge and 3 months post-discharge.</div></div><div><h3>Results</h3><div>A total of 615 patients were recruited, 279 from secondary and 336 from tertiary care; mean age 69 years, mean FEV₁ 45 % predicted, mean CAT score 19.1. All had one or more moderate/severe exacerbations in the previous year, mean 1.5 per year, mean hospitalisation 1.4 per year. Only 47 % reported using inhaled maintenance, triple therapy in 28 % and ICS/LABA in 18 %. Maintenance treatment was started in 88 % of patients who were not receiving it, but most patients on a dual therapy (≥69 %) were not stepped up. There was no difference between GOLD group C vs A or D vs B in treatment prescription suggesting that exacerbation history was not considered, however LAMA/LABA was associated with higher mMRC score, ICS/LABA with higher CAT score and triple therapy with GOLD grade.</div></div><div><h3>Conclusions</h3><div>Despite a high hospitalisation rate, there was under-use of treatment to reduce the risk of exacerbations and failure to step up patients on existing maintenance treatment when they had a severe exacerbation. There was an association between treatment and symptoms and airflow limitation, but physicians did not appear to select treatment based on exacerbation history.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108648"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990598","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}