International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Global Co-Occurrence of COPD and Peripheral Artery Disease in Older Adults: A Machine Learning Analysis of Spatial Patterns and Population-Attributable Risks.","authors":"Shen Liu, Xuehong Jia, Tianxu Han, Zeye Liu, Jing Xie, Guojing Han, Chengliang Yin","doi":"10.2147/COPD.S624329","DOIUrl":"10.2147/COPD.S624329","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) and peripheral artery disease (PAD) significantly contribute to morbidity and mortality among older adults. The geographic co-occurrence may indicate shared exposures; however, global population-level evidence remains scarce.</p><p><strong>Methods: </strong>Utilizing Global Burden of Disease (GBD) 2021 estimates, the analysis focused on COPD and PAD incidence in adults aged ≥ 70 years across 202 countries and territories. Disease-specific incidence quartiles characterized spatial co-occurrence. Random forest models with SHAP (Shapley Additive Explanations) ranked exposure contributions, while negative binomial regression with population offsets estimated associations and population-attributable fractions (PAFs). A quartile-based composite risk index summarized cumulative exposure.</p><p><strong>Results: </strong>The global median incidence was 1150.16 per 100,000 for COPD and 695.4 per 100,000 for PAD. High-incidence regions exhibited partial geographic overlap. Smoking, high LDL cholesterol, and kidney dysfunction correlated with the incidence of both diseases, whereas several additional exposures were disease-specific. Elevated LDL cholesterol had the largest positive association with COPD incidence (RR 1.149), whereas high sugar-sweetened beverage intake exhibited the largest positive association among PAD-specific exposures (RR 1.059). Model-derived cumulative PAFs were 29.7% for COPD and 23.7% for PAD.</p><p><strong>Conclusion: </strong>COPD and PAD demonstrate distinct yet overlapping global spatial patterns among older adults, sharing several population-level exposure correlates. Due to the cross-sectional and ecological nature of this study, the observed associations and PAFs should not be interpreted as individual-level causal effects. These findings may inform regional public health planning and generate hypotheses for prospective validation of integrated cardiopulmonary risk assessment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"624329"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217056","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":"Global, Regional, and National Burden of Chronic Obstructive Pulmonary Disease-Associated Heart Failure: A Systematic Analysis of the Global Burden of Disease Study from 1990 to 2021 with Projections up to 2050.","authors":"Can Liu, Haitian Zhang, Zhengyan Wang, Hongjin Shi, Lingdan Chang, Zhifang Ruan, Yan Li, Ming Qiu, Ping Chu Li, Jinsong Zhang, Bing Hai","doi":"10.2147/COPD.S628759","DOIUrl":"10.2147/COPD.S628759","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is strongly linked to heart failure (HF), but comprehensive global evaluations of COPD-associated HF remain limited.</p><p><strong>Methods: </strong>Using Global Burden of Disease Study 2021 data, we assessed prevalence and years lived with disability (YLDs) of COPD-associated HF. We applied decomposition analysis, Joinpoint regression, and Bayesian age-period-cohort modeling to evaluate trends by sex, age, sociodemographic index (SDI), and region, and to project burden to 2050.</p><p><strong>Results: </strong>In 2021, global COPD-associated HF cases exceeded 3.61 million, a 1.4-fold increase since 1990. Age-standardized prevalence rates (ASPR) and YLD rates (ASYR) increased overall. Absolute cases and YLDs rose in both sexes, but age-standardized rates declined in males and rose in females. Burden peaked at ages 70-74 and grew fastest among those aged ≥95. The Middle SDI region had the highest counts; East Asia had the highest regional burden, and China the highest national absolute burden. Only High-SDI regions showed rising ASPR and ASYR; most other regions declined, notably Eastern Europe. Projections indicate global increases in ASPR and ASYR from 2022 to 2050, with slightly higher rises in females than males.</p><p><strong>Conclusion: </strong>The global burden of COPD-associated HF continues to rise with substantial heterogeneity and is projected to increase further. Coordinated international efforts and targeted prevention and management are urgently needed.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"628759"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217186","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":"Joint Association of Questionnaire-Defined COPD and Widened Pulse Pressure with Incident Cardiovascular Disease in Older Chinese Adults: A 7-Year CHARLS Cohort Study.","authors":"Guangming Liu, Yulu Zou, Yuanyuan Zhou","doi":"10.2147/COPD.S640995","DOIUrl":"10.2147/COPD.S640995","url":null,"abstract":"<p><strong>Purpose: </strong>COPD and vascular aging frequently coexist in later life. Whether widened pulse pressure identifies older adults with COPD at particularly high cardiovascular risk is uncertain.</p><p><strong>Patients and methods: </strong>We analyzed CHARLS participants aged 60 years or older without baseline heart disease or stroke. Questionnaire-defined COPD and widened pulse pressure (≥60 mmHg) formed four phenotypes. The primary outcome was incident physician-reported heart disease or stroke; all-cause mortality was secondary, and heart disease and stroke were component outcomes. Weighted cause-specific Cox models used respondent weights and household-cluster robust standard errors. Because the joint phenotype was selected after an exploratory screen of candidate vascular indicators, this study should be interpreted as hypothesis-generating rather than confirmatory.</p><p><strong>Results: </strong>Among 4183 participants, 943 developed incident cardiovascular disease and 685 died. Relative to neither exposure, COPD alone (adjusted hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.84-1.57) and widened pulse pressure alone (HR 0.93, 95% CI 0.70-1.25) were not associated with cardiovascular disease, whereas both exposures were (HR 1.86, 95% CI 1.26-2.76). The cardiovascular association was present for heart disease (HR 2.80, 95% CI 1.94-4.05) but not stroke (HR 0.84, 95% CI 0.43-1.65). The composite cardiovascular signal should therefore not be read as a uniform effect across cardiovascular systems. For all-cause mortality, the both-exposure group had 63 deaths among 209 participants and a fully adjusted HR of 2.05 (95% CI 1.54-2.73) versus neither exposure, but mortality was not clearly higher than in the COPD-only group (HR 1.37, 95% CI 0.96-1.95).</p><p><strong>Conclusion: </strong>Coexisting questionnaire-defined COPD and widened pulse pressure was associated with a higher risk of incident cardiovascular disease, primarily reported heart disease, and with higher all-cause mortality than neither exposure, although mortality was not clearly higher than among participants with COPD alone. These findings are hypothesis-generating and warrant external validation using objective pulmonary and vascular measures.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"640995"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217234","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":"CFTR I556V Variant Exacerbates Cigarette Smoke-Induced Airway Inflammation in COPD by Promoting NLRP3 Inflammasome Activation.","authors":"Hui Xu, Chengna Luo, Yunfei Zeng, Jiaqi Wang, Ge Bai, Zhaohui Liu, Feng Guo, Zhongfang Wang, Lei Yang, Zhuxiang Zhao","doi":"10.2147/COPD.S597694","DOIUrl":"10.2147/COPD.S597694","url":null,"abstract":"<p><strong>Background and objective: </strong>Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are known to cause cystic fibrosis (CF), a condition that shares several pathophysiological pulmonary features with chronic obstructive pulmonary disease (COPD). Despite these similarities, the relationship between CFTR gene mutations and the risk of developing COPD remains unclear and poorly understood.</p><p><strong>Methods: </strong>We employed exon sequencing to detect CFTR exon variations in 208 COPD patients and 100 control subjects with normal lung function. Subsequently, we applied the adenine base editor system to generate cells and animal models carrying the CFTR chr7:117227874A>G (I556V) variant. Airway epithelial cell models were used to examine the effect of the I556V variant on reactive oxygen species (ROS) levels and mitochondrial membrane potential. Additionally, conventional I556V-CFTR variant (<i>CFTR^V/V</i> ) and wild-type (<i>CFTR^I/I</i> ) mice were exposed to either air or 6 months of cigarette smoke. Immune cell counts were obtained from bronchoalveolar lavage fluid (BALF) samples.</p><p><strong>Results: </strong>Clinically, we identified seven CFTR variants, with I556V showing a significant association with COPD risk (P = 0.045). Individuals carrying the I556V variant had a 2.12-fold increased risk of developing COPD (OR = 2.12, 95% CI = 1.16-3.86), which increased to 96% after adjusting for age, gender, and smoking status (OR = 1.96, 95% CI = 1.01-3.81). Cells harboring the I556V-CFTR variant exhibited a 27.27% increase in ROS levels and an 85.38% increase in the JC-1 monomer ratio (indicating significant loss of mitochondrial membrane potential) compared to <i>CFTR^I/I</i> cells. In mice, the I556V-CFTR variant led to significant impairment of lung function and exacerbated airway remodeling after 6 months of cigarette smoke (CS) exposure, characterized by a 23.03% increase in airway wall thickness and a 48.40% increase in collagen deposition compared to CS-exposed <i>CFTR^I/I</i> mice. Moreover, there was exacerbated lung inflammation in I556V-CFTR variant mice compared to <i>CFTR^I/I</i> .</p><p><strong>Conclusion: </strong>In conclusion, the I556V-CFTR variant is a risk factor for COPD. It likely contributes to disease pathogenesis by downregulating CFTR expression, thereby exacerbating oxidative stress and inflammatory responses.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"597694"},"PeriodicalIF":4.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217117","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":"Development, Validation, and Deployment of an Interpretable Machine Learning Model for In-Hospital Mortality Prediction in Critically Ill Patients with COPD and Sepsis: A Multicenter Cohort Study.","authors":"Jianjie Ju, Jingjing Chen, Gaojin Li, Jingting Wang, Limei Yang","doi":"10.2147/COPD.S643148","DOIUrl":"10.2147/COPD.S643148","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients with chronic obstructive pulmonary disease (COPD) and sepsis are at high risk of in-hospital mortality because of respiratory and organ dysfunction. Early risk assessment may be useful for clinical decision-making. This study aimed to develop an interpretable machine learning model for this population.</p><p><strong>Methods: </strong>Data were extracted from MIMIC-IV and the eICU Collaborative Research Database (eICU-CRD). The MIMIC-IV cohort was split in a 7:3 ratio into training and internal test sets. Features were selected using least absolute shrinkage and selection operator regression and Boruta. Eight models were trained using 10-fold cross-validation and grid search. The best-performing model was externally validated using eICU-CRD, interpreted using Shapley Additive Explanations (SHAP), and compared with the Sequential Organ Failure Assessment (SOFA) score.</p><p><strong>Results: </strong>Among 4,900 MIMIC-IV patients, in-hospital mortality was 19.2%. In the internal test set, the naive Bayes (NB) model achieved an area under the receiver operating characteristic curve (AUC) of 0.743 (95% CI, 0.711-0.775), outperforming the SOFA score (AUC, 0.696, 95% CI, 0.663-0.730, <i>P</i> < 0.001). In external validation, AUC decreased to 0.681 (95% CI, 0.607-0.755), an absolute reduction of 0.062. SHAP identified Simplified Acute Physiology Score II and SOFA as predictors, followed by the anion gap and urine output. The model was deployed across web, desktop, and mobile platforms.</p><p><strong>Conclusion: </strong>An NB model was successfully developed to predict in-hospital mortality in critically ill patients with COPD and sepsis. Further prospective multicenter validation is warranted before routine clinical use.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"643148"},"PeriodicalIF":4.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217090","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":"Development and Real-World Evaluation of an Interpretable Machine Learning Framework for Predicting COPD-Related Healthcare Costs.","authors":"Yi-Li Chen, Guan-Heng Liu, Chin-Ling Li, Chih-Yuan Yang, Fu-Jong Shih, Su-Er Guo, Shih-Feng Liu","doi":"10.2147/COPD.S639817","DOIUrl":"https://doi.org/10.2147/COPD.S639817","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) imposes a substantial economic burden. While machine learning (ML) enables data-driven cost prediction, real-world benchmarking comparing algorithms, data-splitting strategies, and feature optimization on continuous, skewed healthcare expenditures remains limited.</p><p><strong>Objective: </strong>To develop an interpretable ML framework for predicting annual COPD-related healthcare expenditures, assessing the impact of algorithm selection, train-test split ratios, and feature optimization.</p><p><strong>Methods: </strong>We analyzed a retrospective cohort of 396 COPD patients from a Taiwanese medical center. Annual healthcare costs were log-transformed and standardized due to extreme skewness. Five ML regression algorithms were benchmarked across four train-test split ratios. Recursive feature elimination with cross-validation (RFECV) applied within training sets identified an optimal predictor subset. Model interpretability was assessed using SHapley Additive exPlanations (SHAP). Performance was evaluated using R-squared (R²) and mean absolute error (MAE).</p><p><strong>Results: </strong>The 80:20 split yielded the most stable generalization performance. Gradient Boosting achieved the highest accuracy (test R²=0.365; MAE=0.258 on log-transformed scale, ~NTD 82,400 raw scale), outperforming baseline models. RFECV identified six key predictors-Age × BMI, malignancy, exacerbation frequency, Charlson Comorbidity Index, and DOSE index-retaining >95% of full-model performance. SHAP analysis confirmed their clinical relevance.</p><p><strong>Conclusion: </strong>Gradient Boosting provides robust predictive performance for COPD healthcare costs. A parsimonious six-feature set enhances interpretability without compromising accuracy. This explainable ML framework supports cost-aware healthcare management, pending future multi-center validation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"639817"},"PeriodicalIF":4.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185472","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":"The Prognostic Value of PaCO₂ on the Response to Noninvasive Ventilation in Patients with AECOPD Complicated by Type II Respiratory Failure.","authors":"Fanghong Song, Yadong Zhao, Chao Yu","doi":"10.2147/COPD.S639959","DOIUrl":"10.2147/COPD.S639959","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by Type II respiratory failure frequently requires noninvasive ventilation (NIV). However, 10-25% of patients fail NIV and require intubation. The optimal timing and threshold of partial pressure of arterial carbon dioxide (PaCO₂) for predicting NIV failure remain unclear.</p><p><strong>Methods: </strong>In this two-center retrospective cohort study of 676 patients with AECOPD and Type II respiratory failure treated with NIV between 2012 and 2025, we used multivariable logistic regression and restricted cubic spline (RCS) analysis (4 knots at the 5th, 35th, 65th, and 95th percentiles) to assess the dose-response relationship between 24-hour post-treatment PaCO₂ and NIV failure.</p><p><strong>Results: </strong>NIV failure occurred in 73 patients (10.8%). After full adjustment for age, heart rate, white blood cell count, hemoglobin, albumin, blood urea nitrogen, D-dimer, and baseline HACOR score, each 1 mmHg increase in 24h PaCO₂ was associated with 3% higher odds of NIV failure (OR 1.03, 95% CI 1.01-1.06). RCS analysis revealed a nonlinear L-shaped association (overall <i>P</i> < 0.001; nonlinear <i>P</i> < 0.01), with a threshold at 60.2 mmHg. Below this threshold, no significant association was observed; above it, odds increased markedly; this threshold requires further external validation in independent patient populations. After adjustment for confounding variables, the fully‑adjusted multivariable model yielded an AUC of 0.805 (95% CI 0.751-0.860).</p><p><strong>Conclusion: </strong>A 24-hour post-treatment PaCO₂ exceeding 60.2 mmHg identifies patients at high risk for NIV failure. This readily available bedside measure may guide escalation decisions in AECOPD with Type II respiratory failure.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"639959"},"PeriodicalIF":4.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184249","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":"Single-Cell Transcriptomics Reveals Macrophage Dysfunction and cDC2 Activation in COPD: Candidate Biomarkers for Individualized Nursing Care.","authors":"Wenjuan Liu, Luxuan Fan, Jing Yang","doi":"10.2147/COPD.S636559","DOIUrl":"https://doi.org/10.2147/COPD.S636559","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality driven by dysregulated airway immunity. Macrophages and conventional type 2 dendritic cells (cDC2s) are central orchestrators of this process, yet their transcriptional heterogeneity at single-cell resolution and relationship to clinical severity remain incompletely characterized.</p><p><strong>Methods: </strong>We performed integrative analysis of single-cell RNA sequencing (scRNA-seq) data from 45,708 lung immune cells combined with bulk microarray data from 236 lung tissue samples. After Harmony-based batch correction and graph-based clustering, 11 immune cell populations were annotated. Pseudobulk differential expression was performed using DESeq2, functional enrichment by gene set enrichment analysis against MSigDB Hallmark, KEGG, and GO:BP gene sets, and protein-protein interaction (PPI) network analysis using STRINGdb. Clinical correlation used Spearman rank correlation between hub gene expression and GOLD stage, FEV1% predicted, emphysema index, and DLCO%.</p><p><strong>Results: </strong>Macrophages were depleted in COPD while cDC2s were 4.7-fold expanded. Macrophages exhibited 1,268 differentially expressed genes dominated by IFN-γ response (NES = 2.60) and TNFα/NF-κB activation (NES = 2.41), with concurrent loss of mitochondrial function (NES = -2.40) and lysosomal acidification (NES = -2.25). cDC2s showed strong TNFα/NF-κB (NES = 2.88) and JAK-STAT (NES = 2.36) activation. PPI analysis identified IFNG, IL1B, CCR7, GZMB, and NFKB1 as central hubs. Cross-dataset validation confirmed LRG1, CCR7, IRF4, and TIMP1 as clinically correlated biomarkers.</p><p><strong>Conclusion: </strong>This study identifies coordinated macrophage M1 polarization, metabolic dysfunction, and impaired efferocytosis in COPD, with cDC2-driven adaptive immune amplification. Eleven candidate biomarkers are proposed as targets for individualized nursing monitoring and precision respiratory care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"636559"},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185501","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":"Association Between Cardiovascular Comorbidities and Clinical Outcomes in Patients Hospitalized for AECOPD.","authors":"Yuxiao Fu, Jie Hao, Yin Zeng, Wen Qi, Lin Chen, Jiao Li, Xuwen Wang, Ganggang Yu","doi":"10.2147/COPD.S641728","DOIUrl":"https://doi.org/10.2147/COPD.S641728","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the association of cardiovascular disease (CVD) count and combinations with prolonged length of stay (LOS) and 1-year acute exacerbation of chronic obstructive pulmonary disease (AECOPD)-related readmission among patients hospitalized for AECOPD.</p><p><strong>Patients and methods: </strong>This single-centre retrospective study included 3684 admissions from 2281 patients with AECOPD between 2015 and 2024, without adjustment for baseline COPD severity. The assessed CVDs were hypertension (HTN), ischemic heart disease (IHD), arrhythmia, heart failure (HF), and peripheral arterial disease (PAD). The primary outcome was prolonged LOS, defined as a hospital stay of ≥14 days. Generalized estimating equation logistic regression models and Cox models with patient-level clustering were used to evaluate prolonged LOS and 1-year AECOPD-related readmission, respectively. Subgroup and sensitivity analyses assessed the robustness of the findings for prolonged LOS.</p><p><strong>Results: </strong>At least one CVD was present in 71.7% of admissions. After full adjustment, 2 CVDs (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.18-2.16) and ≥3 CVDs (OR: 1.95; 95% CI: 1.30-2.93) were associated with prolonged LOS (P for trend <0.001). The adjusted hazard ratios for 1-year AECOPD-related readmission were 1.38, 1.42, and 1.68 for 1, 2, and ≥3 CVDs, respectively (P for trend = 0.006). HTN + IHD + PAD showed the strongest association with prolonged LOS (OR: 2.53; 95% CI: 1.25-5.12). HTN + Arrhythmia was associated with both prolonged LOS (OR: 1.83; 95% CI: 1.15-2.92) and readmission (hazard ratio: 1.59; 95% CI: 1.04-2.45). Associations of CVD count with prolonged LOS remained generally consistent in subgroup and sensitivity analyses.</p><p><strong>Conclusion: </strong>Increasing CVD count was associated with progressively higher risks of prolonged LOS and 1-year AECOPD-related readmission, with the association with prolonged LOS becoming evident from two coexisting CVDs. Associations with these outcomes varied across CVD combinations, suggesting that both CVD count and combination may help identify patients at increased risk of adverse hospital and post-discharge outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"641728"},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185494","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":"Neuromuscular, Balance, and Gait Factors Associated with Falls and Fall-Related Outcomes in Individuals with COPD: A Systematic Review.","authors":"Mahsa Zangi, Hasan Shamsi, Amir Rahmani Rasa, Hannaneh Mirsaeidi, Aysan Nemati, Mobina Khosravi","doi":"10.2147/COPD.S635248","DOIUrl":"10.2147/COPD.S635248","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic obstructive pulmonary disease (COPD) have a higher incidence of falls than age-matched peers, which may result in injury, loss of independence, and reduced quality of life. Although falls have often been attributed to general deconditioning, impairments in muscle strength, balance, and gait may also contribute. This systematic review synthesized evidence on the relationships between these factors and falls or fall-related outcomes in people with COPD.</p><p><strong>Methods: </strong>PubMed, Web of Knowledge, Scopus and Google Scholar were searched for English-language studies published up to November 2024. Twenty-five original studies involving 1295 participants met the inclusion criteria. Methodological quality was assessed using a modified Downs and Black checklist.</p><p><strong>Results: </strong>Seventeen of the 25 studies reported a significant association between at least one examined factor and fall history or fall risk. Balance impairment showed the most consistent relationship, with positive associations reported in 14 of 17 studies. Evidence regarding muscle strength was mixed: some studies linked quadriceps weakness to increased fall risk, including one reporting an odds ratio of 2.9, whereas others found no significant association. Altered gait characteristics, particularly increased step-time variability, were also associated with falls.</p><p><strong>Conclusion: </strong>Balance and gait impairments are consistently associated with falls and fall-related outcomes in individuals with COPD, whereas the relationship with muscle strength is less consistent. Given the predominance of observational studies, prospective research and controlled trials are needed to clarify causal pathways and determine whether targeted balance and strength training can reduce fall risk as part of pulmonary rehabilitation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"635248"},"PeriodicalIF":4.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170155","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}