Respiratory Medicine and Research最新文献

{"title":"Physical activity and idiopathic pulmonary fibrosis: A prospective cohort study in UK Biobank and Mendelian randomization analyses","authors":"Qing Liang ,&nbsp;Guangchun Sun ,&nbsp;Jiuling Deng ,&nbsp;Qingqing Qian ,&nbsp;Yougen Wu","doi":"10.1016/j.resmer.2024.101141","DOIUrl":"10.1016/j.resmer.2024.101141","url":null,"abstract":"<div><h3>Introduction</h3><div>The impact of physical activity on the incidence of idiopathic pulmonary fibrosis (IPF) remains less well studied. This study aimed to investigate the relationship between moderate-to-vigorous physical activity (MVPA) and the risk of developing IPF.</div></div><div><h3>Methods</h3><div>We analyzed data from a prospective cohort study within the UK Biobank involving 502,476 participants. Participants were categorized as meeting or not meeting the 2017 UK Physical Activity Guidelines (150 min of moderate activity or 75 min of vigorous activity per week). The cumulative incidence and hazard ratios (HRs) for IPF were analyzed using the Kaplan–Meier method, log-rank test, and Cox regression. Two-sample Mendelian randomization (MR) analyses were performed to identify potential causal links between physical activity and IPF risk.</div></div><div><h3>Results</h3><div>Over a median of 12.2 y follow-up, we identified 1,639 incident IPF cases and 395,172 controls. Individuals who met the physical activity guidelines had a significantly lower risk of IPF than those who did not meet the guidelines (adjusted HR = 0.843, 95 % confidence interval [CI] = 0.765–0.930).The cumulative incidence of IPF was lower in the meeting guideline group than in the nonmeeting guideline group (Log-rank <em>P</em> = 0.0019). Two-sample MR analysis revealed that a 1-standard deviation increase in moderate-to-vigorous physical activity was linked to a reduced IPF risk (odds ratio [OR] = 0.17, 95 % CIs = 0.04 to 0.81, <em>P</em> = 0.026). Moreover, an increase in the number of days per week of moderate physical activity was genetically correlated with decreased IPF risk (OR = 0.32, 95 % CIs = 0.15–0.70, <em>P</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>Higher levels of moderate-to-vigorous physical activity are causally associated with a significant reduction in the risk of developing IPF.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101141"},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission chest CT scan of intensive care patients with interstitial lung disease: Unveiling its limited predictive value through visual and automated analyses in a retrospective study (ILDICTO)","authors":"Vincent Joussellin ,&nbsp;Eric Meneyrol ,&nbsp;Mathieu Lederlin ,&nbsp;Stéphane Jouneau ,&nbsp;Nicolas Terzi ,&nbsp;Jean-Marc Tadié ,&nbsp;Arnaud Gacouin","doi":"10.1016/j.resmer.2024.101140","DOIUrl":"10.1016/j.resmer.2024.101140","url":null,"abstract":"<div><h3>Background</h3><div>Clinical course prediction of patients with interstitial lung disease (ILD) admitted to the intensive care unit (ICU) for acute respiratory failure (ARF) can be challenging. This study aimed to characterize the prognostic value of admission chest CT-scan in this situation.</div></div><div><h3>Methods</h3><div>We retrospectively included ILD patients admitted to a French ICU for acute respiratory failure requiring oxygen. Patients with lymphangitis carcinomatosis and ANCA vasculitis were excluded. We analyzed every admission chest CT-scan using two different approaches: a visual analysis (grading the extent of traction bronchiectasis, ground glass and honeycomb) and an automated analysis (grading the extent of ground glass and consolidation with a dedicated software). The primary outcome was ICU mortality.</div></div><div><h3>Results</h3><div>Between January 2014 and October 2020, 81 patients presented an acute respiratory failure with ILD on the admission chest CT-scan. In univariate analysis, only the main pulmonary artery diameter differed between patients who survived and those who died in ICU (30 vs 32 mm, <em>p</em> = 0.021). In multivariate analysis, none of the radiological funding was associated with ICU mortality. Visual and automated analyses did not yield different results, with a strong correlation between the two methods. However, the identification of an UIP pattern (and the presence of honeycomb) was associated with a poorer response to corticosteroid therapy.</div></div><div><h3>Conclusion</h3><div>Our study showed that the extent of radiological findings and the severity of fibrosis indices on admission chest CT scans of ILD patients admitted to the ICU for ARF were not associated with subsequent deterioration.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101140"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated serum angiotensin converting enzyme correlates with specific HLA-DRB1 alleles and extrapulmonary manifestations in sarcoidosis","authors":"Marios Rossides ,&nbsp;Vasiliki Megadimou ,&nbsp;Anna Smed-Sörensen ,&nbsp;Anders Eklund ,&nbsp;Susanna Kullberg ,&nbsp;Pernilla Darlington","doi":"10.1016/j.resmer.2024.101142","DOIUrl":"10.1016/j.resmer.2024.101142","url":null,"abstract":"<div><h3>Background</h3><div>Genetics influence the clinical picture in sarcoidosis, a granulomatous heterogeneous disease often accompanied by elevated serum angiotensin converting enzyme (s-ACE). We aimed to investigate if certain HLA-DRB1 alleles correlate with the levels of s-ACE, known as a marker of the granuloma burden.</div></div><div><h3>Methods</h3><div>Medical journals of patients with sarcoidosis from a Swedish clinical registry were retrospectively examined to extract the highest recorded s-ACE value and analysed in relation to patient characteristics including phenotype [Löfgren syndrome (LS)/ non-LS], chest X-ray staging according to Scadding, treatment with immunosuppressants, presence of extrapulmonary manifestations (EPM), HLA-DRB1 alleles and prognosis (resolving vs. non-resolving disease within 2 years). Data were analysed with Fisher's exact test and Bonferroni correction was applied for HLA analyses.</div></div><div><h3>Results</h3><div>Of 1204 patients included, 40% had s-ACE levels above reference value. In comparison with patients with normal s-ACE, those with elevated levels were more often classified into non-LS (78% vs 59%, <em>p</em> &lt; 0.001), and Scadding stage II (50% vs 38%, <em>p</em> &lt; 0.001) but less often Scadding stage I (33% vs 46%, <em>p</em> &lt; 0.001) and had more often EPM (45% vs 23%, <em>p</em> &lt; 0.001). The patients with HLA-DRB1×04 had more often elevated s-ACE (<em>p</em> &lt; 0.01) while those with HLA-DRB1×03 commonly had normal levels (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In this retrospective study, HLA alleles associated with s-ACE levels in sarcoidosis patients, which in turn correlated with occurrence of EPM. These findings shed some new light on possible mechanisms behind differences in s-ACE levels.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101142"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How safe is lung transplantation in patients of 65 years or older? A single-center retrospective cohort","authors":"Alla Avramenko ,&nbsp;Harry Etienne ,&nbsp;Gaëlle Weisenburger ,&nbsp;Jimmy Mullaert ,&nbsp;Pierre Cerceau ,&nbsp;Quentin Pellenc ,&nbsp;Arnaud Roussel ,&nbsp;Lise Morer ,&nbsp;Vincent Bunel ,&nbsp;Philippe Montravers ,&nbsp;Hervé Mal ,&nbsp;Yves Castier ,&nbsp;Jonathan Messika ,&nbsp;Pierre Mordant ,&nbsp;Bichat Lung Transplant Group","doi":"10.1016/j.resmer.2024.101139","DOIUrl":"10.1016/j.resmer.2024.101139","url":null,"abstract":"<div><h3>Introduction</h3><p>With increasing experience in high-volume centers, age alone should not be an absolute contra-indication to lung transplantation (LT) but be considered as part of the patient's initial characteristics. The objective of this study is to provide early and long-term outcomes of LT in recipients aged 65 or older, compared with their younger counterparts.</p></div><div><h3>Methods</h3><p>This is a retrospective study, including all patients undergoing LT in Bichat Hospital (Paris, France) from January 2014 to March 2019. Two groups were defined depending on the patients’ age when they were transplanted: patients older than 65 were defined as the “elderly group” and patients younger than 65 years old were defined as the « younger group ». Primary endpoint was 90-day mortality. Secondary endpoints included 1-year mortality, 1-year FEV1 (forced expiratory volume in one second), and 5-year overall survival.</p></div><div><h3>Results</h3><p>From September 2014 to March 2019, 22 patients were included in the “elderly group” and 213 were included in the « younger group ». The elderly group had more single LT (SLT) (82% vs. 29%, <em>p</em> &lt; 0.001), with a shorter cold ischemic time (243 min vs. 310 min, <em>p</em> = 0.001) and a lower rate of early humoral rejection (9% vs. 30%, <em>p</em> = 0.045) compared to the younger group. Ninety-day mortality was not significantly different between elderly and younger group (9% vs. 14%, <em>p</em> = 0.95, respectively), nor were 1-year mortality (23% vs. 25%, <em>p</em> = 0.9, respectively) and 5-year overall survival. Six months after LT, FEV1 was significantly better in the elderly group compared to the younger group (77.0% vs. 65.5%, <em>p</em> = 0.037 respectively), but the difference did not reach statistical significance after one year (78.5 vs. 68.3%, <em>p</em> = 0.18 respectively).</p></div><div><h3>Conclusion</h3><p>Elderly patients underwent more frequently single LT, and achieved similar short and long term postoperative outcomes compared to their younger counterparts. LT for patients 65 years or older should be routinely considered when carefully selected.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101139"},"PeriodicalIF":2.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000552/pdfft?md5=70075cd911eeb6e7ecf47944c4e0a38d&pid=1-s2.0-S2590041224000552-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcoid-like reaction related to ALK-ROS inhibitors in lung cancer patients","authors":"Clara Morin ,&nbsp;Thomas Villeneuve,&nbsp;Emma Norkowski,&nbsp;Lise Rosencher,&nbsp;Jacques Cadranel,&nbsp;Julien Mazières","doi":"10.1016/j.resmer.2024.101138","DOIUrl":"10.1016/j.resmer.2024.101138","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101138"},"PeriodicalIF":2.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental pulmonary nodules: Natural language processing analysis of radiology reports","authors":"Emmanuel Grolleau ,&nbsp;Sébastien Couraud ,&nbsp;Emilien Jupin Delevaux ,&nbsp;Céline Piegay ,&nbsp;Adeline Mansuy ,&nbsp;Julie de Bermont ,&nbsp;François Cotton ,&nbsp;Jean-Baptiste Pialat ,&nbsp;François Talbot ,&nbsp;Loïc Boussel","doi":"10.1016/j.resmer.2024.101136","DOIUrl":"10.1016/j.resmer.2024.101136","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary nodules are a common incidental finding on chest Computed Tomography scans (CT), most of the time outside of lung cancer screening (LCS). We aimed to evaluate the number of incidental pulmonary nodules (IPN) found in 1 year in our hospital, as well as the follow-up (FUP) rate and the clinical and radiological features associated with FUP.</p></div><div><h3>Methods</h3><p>We trained a Natural Language Processing (NLP) tool to identify the transcripts mentioning the presence of a pulmonary nodule, among a large population of patients from a French hospital. We extracted nodule characteristics using keyword analysis. NLP algorithm accuracy was determined through manual reading from a sample of our population. Electronic health database and medical record analysis by clinician allowed us to obtain information about FUP and cancer diagnoses.</p></div><div><h3>Results</h3><p>In this retrospective observational study, we analyzed 101,703 transcripts corresponding to the entire CTs performed in 2020. We identified 1,991 (2 %) patients with an IPN. NLP accuracy for nodule detection in CT reports was 99 %. Only 41 % received a FUP between January 2020 and December 2021. Patient age, nodule size, and the mention of the nodule in the impression part were positively associated with FUP, while nodules diagnosed in the context of COVID-19 were less followed. 36 (2 %) lung cancers were subsequently diagnosed, with 16 (45 %) at a non-metastatic stage.</p></div><div><h3>Conclusions</h3><p>We identified a high prevalence of IPN with a low FUP rate, encouraging the implementation of IPN management program. We also highlighted the potential of NLP for database analysis in clinical research.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101136"},"PeriodicalIF":2.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000527/pdfft?md5=db4810650b3b1f71ba6bb1bfcd967a3b&pid=1-s2.0-S2590041224000527-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the correspondence between the EQ-5D-5L and disease severity and quality of life in adults and adolescents with cystic fibrosis","authors":"Rana Altabee ,&nbsp;Siobhan B. Carr ,&nbsp;Janice Abbott ,&nbsp;Rory Cameron ,&nbsp;Daniel Office ,&nbsp;Nicholas J. Simmonds ,&nbsp;Jennifer A. Whitty ,&nbsp;David Turner ,&nbsp;Garry Barton","doi":"10.1016/j.resmer.2024.101137","DOIUrl":"10.1016/j.resmer.2024.101137","url":null,"abstract":"<div><h3>Background</h3><p>The EQ-5D is the recommended measure to capture health-related quality of life (HRQoL), recognised for use in health technology appraisal bodies. In order to assess whether it is appropriate to use the EQ-5D for making decisions about the cost-utility of treatments in cystic fibrosis (CF), this study assesses the performance of the EQ-5D-5L in adults and adolescents with CF.</p></div><div><h3>Method</h3><p>This was a cross-sectional observational survey study of patients with CF attending a single large CF centre. Participants were asked to complete a survey that included two HRQoL measures; the EQ-5D-5L and CF Quality of Life (CFQoL) questionnaires.</p></div><div><h3>Results</h3><p>Among 213 participants, the median EQ-5D-5L index score was 0.76 (IQR 0.66 – 0.84) and the visual analogue (EQ-VAS) was 70 (60 – 80). Both the EQ-5D index and EQ-VAS discriminated between disease severity based on lung function (<em>p</em> = 0.01 and <em>p</em> &lt; 0.01, respectively) and pulmonary exacerbation (<em>p</em> = 0.02 and <em>p</em> &lt; 0.01, respectively); however, EQ-VAS differentiated between more lung function severity groups compared to EQ-5D index. The EQ-5D-5L demonstrated convergent validity as its dimensions, index score, and EQ-VAS had significant correlations with most CFQoL domains. Though, EQ-VAS significantly predicted more domains of CFQoL (4 domains) compared to EQ-5D index (only 1 domain).</p></div><div><h3>Conclusion</h3><p>The generic EQ-5D-5L performed adequately in discriminating between CF disease severity, and its index score and EQ-VAS had moderate correlations with CFQoL. However, using a complementary condition-specific measure alongside the EQ-5D-5L can provide better insight of HRQoL in CF and benefit the process of cost-utility analysis.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101137"},"PeriodicalIF":2.2,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000539/pdfft?md5=b71da58ca67010b88f93e6e2d262327d&pid=1-s2.0-S2590041224000539-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description, clinical impact and early outcome of S. maltophilia respiratory tract infections after lung transplantation, A retrospective observational study","authors":"Benoît Pilmis ,&nbsp;Claire Rouzaud ,&nbsp;Deborah To-Puzenat ,&nbsp;Anne Gigandon ,&nbsp;Gaelle Dauriat ,&nbsp;Séverine Feuillet ,&nbsp;Delphine Mitilian ,&nbsp;Justin Issard ,&nbsp;Alban Le Monnier ,&nbsp;Olivier Lortholary ,&nbsp;Elie Fadel ,&nbsp;Jérôme Le Pavec","doi":"10.1016/j.resmer.2024.101130","DOIUrl":"10.1016/j.resmer.2024.101130","url":null,"abstract":"<div><h3>Background and research question</h3><p><em>S. maltophilia</em> infections are associated with significant morbidity and mortality. Little is known regarding its presentation, management, and outcome in lung transplant recipients.</p></div><div><h3>Study design and Methods</h3><p>This retrospective case control study reviewed <em>S. maltophilia</em> respiratory tract infection in lung transplant recipients (01/01/2011-31/01/2020) and described the clinical, microbiological and outcome characteristics matched with lung transplant recipients without respiratory tract infection.</p></div><div><h3>Results and interpretation</h3><p>We identified 63 <em>S. maltophilia</em> infections in lung transplant recipients. Among them none were colonized before transplantation. Infections occurred a median of 177 (IQR: 45- 681) days post transplantation. Fifty-four (85.7 %) patients received trimethoprim-sulfamethoxazole (400/80 mg three times a week) to prevent <em>Pneumocystis jirovecii</em> pneumonia (PJP). <em>S. maltophilia</em> strains were susceptible to trimethoprim-sulfamethoxazole, levofloxacin, minocycline and ceftazidime in respectively 85.7 %, 82.5 %, 96.8 % and 34.9 % of cases. Median duration of treatment was 9 days (IQR 7–11.5). Clinical and microbiological recurrence were observed in respectively 25.3 % and 39.7 % of cases. Combination therapy was not associated with a decrease in the risk of recurrence and did not prevent the emergence of resistance. <em>S. maltophilia</em> respiratory tract infection was associated with a decline in FEV-1 at one year.</p></div><div><h3>Conclusion</h3><p><em>S. maltophilia</em> is an important cause of lower respiratory tract infection in lung transplant recipients. Trimethoprim-sulfamethoxazole use as prophylaxis for PJP doesn't prevent <em>S. maltophilia</em> infection among lung transplant recipients. Levofloxacin and trimethoprim-sulfamethoxazole appear to be the two molecules of choice for the treatment of these infections and new antibiotic strategies (cefiderocol, aztreonam/avibactam) are currently being evaluated for multi-resistant <em>S. maltophilia</em> infections.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101130"},"PeriodicalIF":2.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive hemoptysis: A normal platelet count may not be enough","authors":"Thibaud Soumagne,&nbsp;Dominique Helley,&nbsp;Sébastien Eymieux,&nbsp;Laurent Frenzel,&nbsp;Anne Vincenot,&nbsp;Alessandro Di Gaeta,&nbsp;Olivier Pellerin,&nbsp;Benjamin Planquette,&nbsp;Nicolas Gendron","doi":"10.1016/j.resmer.2024.101134","DOIUrl":"10.1016/j.resmer.2024.101134","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101134"},"PeriodicalIF":2.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus with poor glycemic control is a risk factor for pneumonia in COPD","authors":"Rafael Golpe ,&nbsp;Juan-Marco Figueira-Gonçalves ,&nbsp;Laura Arias-Zas ,&nbsp;David Dacal-Rivas ,&nbsp;Nagore Blanco-Cid ,&nbsp;Olalla Castro-Añón","doi":"10.1016/j.resmer.2024.101135","DOIUrl":"10.1016/j.resmer.2024.101135","url":null,"abstract":"<div><h3>Background</h3><p>Pneumonias are events of great prognostic significance in COPD, so it is important to identify predictive factors.</p></div><div><h3>Objective</h3><p>To determine whether poor glycemic control is related to an increased risk of pneumonia in COPD.</p></div><div><h3>Method</h3><p>A historical cohort study conducted in a COPD clinic. The first severe exacerbation after the first visit was analyzed. Exacerbations that presented with pulmonary infiltrates were identified. A Cox proportional hazards analysis was performed including the values of glycosylated hemoglobin (Hb1Ac) in patients with diabetes mellitus (DM) and variables that could plausibly be related to the risk of pneumonia. The best Hb1Ac value to predict pneumonia was assessed using receiver-operating characteristics analysis.</p></div><div><h3>Results</h3><p>There were 1124 cases included in the study. A total of 411 patients were admitted to the hospital at least once and 87 were diagnosed with pneumonia. Variables associated with the risk of pneumonia were previous admissions due to COPD and Hb1Ac values (HR: 2.33, 95% CI: 1.06 – 5.08, <em>p</em> = 0.03). A higher body mass index (BMI) was associated with a lower risk of pneumonia. The optimal cutoff point for Hb1Ac to predict pneumonia risk was 7.8 %. The patients were classified into 3 groups: (1) no DM, (2) controlled DM (Hb1AC &lt; 7.8 %), (3) uncontrolled DM (Hb1AC ≥ 7.8 %). The risk of pneumonia for group 2 was not different from group 1, while the risk for group 3 was significantly higher than for groups 1 and 2 (HR: 4.52, 95 % CI: 1.57 – 13.02).</p></div><div><h3>Conclusions</h3><p>Poor control of DM is a predictor of the risk of pneumonia in COPD. The cutoff point of 7.8 % for this variable seems to be the most useful to identify patients at risk.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101135"},"PeriodicalIF":2.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}