BMC Pulmonary Medicine最新文献

{"title":"Prevalence and clinical impact of bacterial co-infection in chronaturenic pulmonary aspergillosis.","authors":"Fatma Tokgöz Akyıl, Sida Gösterici, Hülya Abalı, Derya Hırçın Cenger, Çiğdem Sabancı, Sinem Sökücü, Sedat Altın","doi":"10.1186/s12890-025-03623-y","DOIUrl":"10.1186/s12890-025-03623-y","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of co-infection with chronic pulmonary aspergillosis (CPA) and bacteria is limited and has mostly been studied in specific patient groups. This study aims to investigate the incidence and prognostic impact of bacterial co-infection in patients with CPA.</p><p><strong>Methods: </strong>A single-center, retrospective, observational study was conducted between 2019 and 2024. Patients were categorized based on the presence of bacterial co-infection, and their demographics, potential underlying factors, and prognosis were analyzed.</p><p><strong>Results: </strong>A total of 101 patients were included (mean age: 57 ± 13 years, 79 male). Bacterial co-infection was identified in 21 patients (21%). The most common bacterial pathogens at diagnosis were Pseudomonas aeruginosa (n = 6), Klebsiella pneumoniae (n = 5), Escherichia coli (n = 4), and Serratia marcescens (n = 4). Five patients had a history of prior bacterial colonization. At diagnosis, more than one bacterial species were identified in six patients. Sputum production and hypoxemic respiratory failure were more frequently observed in patients with bacterial co-infection. Systemic corticosteroid use was more common in the co-infected group. However, radiological findings and diagnostic procedures did not differ between the groups. Surgical interventions were more commonly performed in the non-co-infected group. During the follow-up, hospital admission rates, mortality, and overall survival were comparable between the two groups.</p><p><strong>Conclusions: </strong>Bacterial co-infections are probable in CPA and follow-up results of both patient Groups may not differ. Timely diagnosis and close follow-up of these patients are probable key factors in these patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"155"},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787532","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":"Lactate dehydrogenase to albumin ratio and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study.","authors":"Chao-Wei Ding, Shen-Shen Huang, Yan-Hong Xu, Xu Chu, Lan Wang, Yi-Min Mao, Ya-Dong Yuan, Jia-Yong Qiu","doi":"10.1186/s12890-025-03622-z","DOIUrl":"10.1186/s12890-025-03622-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a global public health challenge and a major cause of death. The lactate dehydrogenase to albumin ratio (LAR) is a simple and practical indicator of disease prognosis, but its prognostic value in acute exacerbation of COPD (AECOPD) remains unclear. Therefore, we aimed to explore the prognostic value of LAR for the short-term all-cause mortality risk in patients with AECOPD.</p><p><strong>Methods: </strong>This retrospective cohort study included 654 patients with AECOPD from the MIMIC-IV database. LAR was analyzed after natural logarithm transformation and the patients were divided into three groups. The clinical outcome was the 1-month and 3-months all-cause mortality. The relationship between LAR and all-cause mortality was assessed using Kaplan-Meier survival analysis and a Cox regression model. Generalized additive models were employed to identify non-linear relationships, and a subgroup analysis was performed to determine the stability of the results.</p><p><strong>Results: </strong>The study showed that LAR levels significantly and positively correlated with short-term all-cause mortality in patients with AECOPD. Compared to the low LAR group, patients in the medium LAR group had a significantly increased 1-month all-cause mortality risk, with a hazard ratio (HR) of 1.74 (95% [Confidence Interval, CI] 1.16-2.63, P = 0.008). Patients in the high LAR group had an even higher 1-month all-cause mortality risk, with an HR of 2.58 (95% CI 1.75-3.80, P < 0.001). For 3-month all-cause mortality, patients in the medium LAR group had an HR of 1.54 (95% CI 1.10-2.16, P = 0.012), while those in the high LAR group had an HR of 2.18 (95% CI 1.58-3.01, P < 0.001). The results remained stable in all three adjusted models and in the subgroup analyses. The relationship between LAR and all-cause mortality due to AECOPD was non-linear, with inflection points at 8.13 and 6.05 for 1-month and 3-month all-cause mortality, respectively.</p><p><strong>Conclusions: </strong>Elevated LAR is an independent predictive indicator of short-term all-cause mortality risk in patients with AECOPD and can be used to improve decision-making for the clinical management of these patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"154"},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787582","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 the geriatric nutritional risk index and adverse post-extubation outcomes for critically ill older adults: a retrospective study.","authors":"Sheng-Chang Ye, Yu-Ting Mao, Bo-Li Huang, Li-Li Hou","doi":"10.1186/s12890-025-03600-5","DOIUrl":"10.1186/s12890-025-03600-5","url":null,"abstract":"<p><strong>Background and purpose: </strong>Malnutrition commonly predicts adverse outcomes among older adults in the intensive care unit (ICU). The Geriatric Nutritional Risk Index (GNRI) is a simple and practical tool for assessing nutritional status in older adults. This study aims to explore the association between GNRI and adverse post-extubation outcomes in critically ill older adults.</p><p><strong>Methods: </strong>A total of 1,153 older adults aged 65-82 years in the ICU were included in this retrospective cohort study. GNRI categories were stratified into four subgroups based on nutritional risk: major risk (GNRI < 82), moderate risk (GNRI 82-91), low risk (GNRI 92-98), and no risk (GNRI > 98). Adverse post-extubation outcomes included mortality or pneumonia within 30 days post-extubation, reintubation within 72 h, post-extubation dysphagia, and length of stay (LOS) in the ICU and hospital. Multivariable logistic regression analysis and restricted cubic spline (RCS) were used to explore the association between GNRI categories and dichotomous adverse outcomes. Additionally, multivariable linear regression was used to evaluate the association between GNRI and LOS in the ICU and hospital.</p><p><strong>Results: </strong>Older adults with dichotomous adverse outcomes had lower GNRI values compared with those without (P-value<0.001), and increasing LOS in ICU and hospital was associated with decreasing GNRI value (P _{for trend}<0.001). Patients at major nutritional risk had the highest risk of mortality [OR = 2.76, 95%CI: 1.40 ∼ 5.46] or pneumonia [OR = 3.07, 95%CI: 1.42 ∼ 6.68] within 30 days post-extubation, reintubation within 72 h [OR = 2.41, 95%CI: 1.06 ∼ 5.49] and post-extubation dysphagia [OR = 2.94, 95%CI: 1.19 ∼ 7.31](P for trend<0.001). The RCS study also validated the linear relationship between GNRI and mortality/pneumonia within 30 days post-extubation and post-extubation dysphagia. Conversely, there were non-linear associations between GNRI and ICU and hospital LOS, as well as reintubation within 72 h. Furthermore, GNRI showed a significant negative correlation with LOS in both the ICU and hospital. Kaplan-Meier curve analysis demonstrated that survival within 30 days post-extubation was significantly reduced in major nutritional risk group compared to the no risk group (P-value = 0.018).</p><p><strong>Conclusions: </strong>Our findings demonstrated that major nutritional risk defined by GNRI was associated with a higher risk of adverse post-extubation outcomes in critically ill older adults.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"151"},"PeriodicalIF":2.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779154","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":"Diagnostic performance of a doppler radar-based sleep apnoea testing device.","authors":"Jonathan Röcken, Andrei M Darie, Leticia Grize, Claire Ellen Dexter, Matthias J Herrmann, Kathleen Jahn, Werner Strobel, Michael Tamm, Daiana Stolz","doi":"10.1186/s12890-025-03618-9","DOIUrl":"10.1186/s12890-025-03618-9","url":null,"abstract":"<p><strong>Background: </strong>Inpatient polysomnography (PSG) is the gold standard for the diagnosis of obstructive sleep apnoea (OSA), however, both complexity and costs limit the availability of this examination. Home sleep apnoea testing devices are a diagnostic alternative in patients with increased risk of OSA. We evaluated the diagnostic performance of a Doppler radar technology based, contactless sleep apnoea testing device (CSATD) in a cohort of patients with a clinically increased risk of OSA.</p><p><strong>Methods: </strong>Monocentric prospective study. Sleep monitoring with the CSATD SleepizOne + without pulse oximetry (Sleepiz AG, Switzerland) was performed simultaneously with elective inpatient PSG. PSG was analysed blinded to the CSATD results and according to AASM 2012 criteria by certified sleep physicians. The CSATD data were analysed automatically and independently by a dedicated software.</p><p><strong>Results: </strong>A total of 102 patients, 60.8% male, with an average age of 55 ± 15 years and body mass index of 30 ± 6 kg/m2 were included in the analysis. The sensitivity and specificity of the CSATD for a PSG apnoea-hypopnoea-index (AHI) of ≥ 5/h were 0.89 (95%CI: 0.83-0.96) and 0.88 (95%CI: 0.73-1.0). The negative and positive predictive values were 0.62 (95%CI: 0.42-0.82) and 0.97 (95%CI: 0.94-1.0). The diagnostic agreement for the diagnosis of OSA (defined as PSG AHI ≥ 5/h) was 89.8% and 100% using a CSATD AHI threshold of ≥ 5/h (n = 79/88) and ≥ 15/h (n = 61/61). However, the concordance was poor in the classification of OSA severity, with 50% (13/26) concordance for mild, 38% (10/26) for moderate, and 76% (25/33) for severe OSA respectively.</p><p><strong>Conclusion: </strong>CSATD accurately identifies patients with OSA, particularly using an AHI threshold of ≥ 15/h. However, it performs subpar in disease severity stratification.</p><p><strong>Clinical trial registration: </strong>This trial was registered on the International Clinical Trials Registry Platform, ISRCTN45778591.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"150"},"PeriodicalIF":2.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779173","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":"Diaphragm thickness and ICU admission risk in elderly COVID-19 patients: a CT-based analysis.","authors":"Mercan Tastemur, Cagla Ozdemir, Esin Olcucuoğlu, Gunes Arik, Ihsan Ates, Kamile Silay","doi":"10.1186/s12890-025-03599-9","DOIUrl":"10.1186/s12890-025-03599-9","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the impact of diaphragm thickness (DT) on the prognosis of elderly patients infected with COVID-19, particularly with regard to the necessity of intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>Between August 2020 and January 2021, 188 patients aged ≥ 65 years who were admitted to the internal medicine department of our hospital with a diagnosis of COVID-19 infection, were included in this study. The patients' DTs of the patients were measured by a radiologist using computed tomography (CT) scans from the right and left diaphragm dome level. DT was compared with the progression of respiratory distress and the necessity of intensive care. In statistical analysis, p < 0.05 was considered significant.</p><p><strong>Results: </strong>Right DT was higher in the group of patients with admission to the ICU (p = 0.11). According to multivariate logistic regression analysis, ferritin level (OR = 1; 95% CI = 1-1; p = 0.014), IL-6 level (OR = 1.004; 95% CI = 1-1.007; p = 0.045) and higher right DT (OR = 11.015; 95% CI = 3.739-32.447; p = 0.035) were found to be independent risk factors predicting the ICU admission in COVID-19 patients. There was no significant association with left DT. The predictive value of right DT for ICU requirement in COVID-19 patients was evaluated by ROC analysis. The ROC analysis showed a cut-off value > 1.8, AUC = 0.632, p = 0.009, 95% Cl (0.558-0.701). In correlation analysis, a positive correlation was found between right DT and ICU admission (r = 0.331, p < 0.001).</p><p><strong>Conclusion: </strong>Our study is the first to evaluate dome-level DT with CT in elderly patients with COVID-19. In the elderly population, higher right DT levels have been observed to enhance the probability of ICU admission. This may be due to the fact that our sample group consists only of elderly people and the effects of COVID-19. We believe that further validation with more comprehensive studies is needed for DT assessment for clinical treatment decisions, particularly in COVID-19 patients. In addition, we think that the proposal for a standardized measurement site and method for DT measurement will be a guide for future studies.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"152"},"PeriodicalIF":2.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779174","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 of obesity on short- and long-term survival in patients with moderate to severe pneumonia-related ARDS: a retrospective cohort study.","authors":"Arnaud Gacouin, Adel Maamar, Nicolas Terzi, Jean-Marc Tadié","doi":"10.1186/s12890-025-03614-z","DOIUrl":"10.1186/s12890-025-03614-z","url":null,"abstract":"<p><strong>Background: </strong>The incidence of obesity among patients admitted to the intensive care unit (ICU) is increasing, and pneumonia remains the leading cause of acute respiratory distress syndrome (ARDS). The association of obesity on both short- and long-term outcomes in patients with pneumonia-induced ARDS has been the subject of only limited research.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of a prospective cohort consisting of ARDS patients who had microbiologically confirmed pneumonia and a PaO₂/FiO₂ ratio ≤ 150 mmHg. Patients were assessed for mortality at 28 days, 90 days, and at 1 year from the diagnosis of ARDS and compared between obese defined by a body mass index (BMI) ≥ 30 kg.m² and non-obese patients. Models were adjusted for age, sex, COPD, coronary artery disease, immunodepression, severity score and acute kidney injury on admission to the ICU, severity of ARDS (PaO₂/FiO₂ ratio ≤ 100 mmHg), severe hypercapnia (PaCO₂ ≥ 50 mmHg), ventilatory ratio and plateau pressure the first day of ARDS, influenza, COVID-19, pneumocystosis, and bacteria involved in pneumonia. We also investigated the continuous spectrum of BMI on the risk of mortality.</p><p><strong>Results: </strong>Of 603 patients, 227 patients (37.6%) were obese. Obesity was associated with female gender (p = 0.009), hypertension (p < 0.001), diabetes mellitus (p < 0.001), COVID-19 pneumonia (p = 0.008), and PaO2/FiO2 ratio ≤ 100 mmHg (p = 0.006). Obesity was independently associated with lower mortality at 28 days (adjusted Odds Ratio (OR) 0.55, 95% confident interval (CI) 0.33-0.90, p = 0.02) but not at 90 days (adjusted OR 0.70, 95% CI 0.45-1.09, p = 0.11) nor at 1 year from the diagnosis of ARDS (adjusted OR 0.73, 95% CI 0.47-1.13, p = 0.16). Mortality at 28 days was significantly lower in obese patients than in non-obese patients when propensity score matching was used (15.2% versus 22%, p = 0.04). BMI was also independently associated with lower mortality at 28 days (p = 0.038) but not with mortality at 90 days (p = 0.12) and 1 year (p = 0.12).</p><p><strong>Conclusion: </strong>Our results suggest that in patients with pneumonia-related ARDS, obesity is independently associated with better survival at 28 days but not at 90 days and 1 year from the diagnosis of ARDS.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"153"},"PeriodicalIF":2.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779170","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 impact of the triglyceride-glucose index on the risk of respiratory failure in patients with COPD: a study from the MIMIC database and Chinese cohorts.","authors":"Shiyu Hu, Ye Zhang, Zhifang Cui, Ye Zhang, Jiaye Wang, Xiaoli Tan, Wenyu Chen","doi":"10.1186/s12890-025-03597-x","DOIUrl":"10.1186/s12890-025-03597-x","url":null,"abstract":"<p><strong>Background: </strong>The Triglyceride-Glucose (TyG) index, a reliable marker for insulin resistance, is now employed to assess the onset and prognosis of various conditions like acute coronary syndrome, chronic kidney disease, and ischemic stroke. However, whether the TyG index can be used to assess respiratory failure (RF) risk among Chronic obstructive pulmonary disease (COPD) patients remains uncertain. The present study aims to delve into the link between the TyG index and the risk of RF in COPD patients.</p><p><strong>Methods: </strong>Individuals with COPD were retrospectively acquired from the MIMIC-IV 2.2 (The Medical Information Mart for Intensive Care IV, version 2.2) database. The association between the TyG index and the probability of RF among COPD patients was evaluated using Cox proportional hazards models and restricted cubic spline (RCS) curves. Cumulative incidence curves were generated to appraise the RF risk across the quartile groups. Finally, 1188 patients were recruited from the First Hospital of Jiaxing City to externally validate the Cox modeling results for the primary outcome.</p><p><strong>Results: </strong>This study incorporated a total of 1,232 participants from MIMIC database. Among these individuals, 134 cases (10.9%) experienced RF. According to Cox regression analysis, a one-unit increment in the TyG index was linked to a 1.821-fold elevated risk of RF in the COPD population (HR, 1.821[95% CI 1.349-2.459], P < 0.001). High TyG index levels were significantly linked to a higher RF risk (HR, 3.510 [95% CI 1.885-6.535], P < 0.001). RCS curve analysis also signaled a linear correlation between the TyG index and RF risk (P-Nonlinear = 0.074).</p><p><strong>Conclusion: </strong>There exists a certain correlation between high-level TyG index and the risk of RF occurrence in COPD patients, indicating promising prospects for utilizing the TyG index to assess the severity of COPD patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"149"},"PeriodicalIF":2.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771152","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":"Impact of initial ventilation strategies on in-hospital mortality in sepsis patients: insights from the MIMIC-IV database.","authors":"Yuxin Lu, Jingtao Zhang, Wanglin Zhang, Hongwei Shi, Kanlirong Wang, Ziang Li, Liqun Sun","doi":"10.1186/s12890-025-03610-3","DOIUrl":"10.1186/s12890-025-03610-3","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the impact of different initial ventilation strategies on in-hospital mortality among sepsis patients.</p><p><strong>Methods: </strong>We included hospitalized sepsis patients who underwent mechanical ventilation from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into groups based on their initial ventilation strategy: non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV). The main endpoint analyzed was in-hospital mortality. A propensity score matching model was employed to address confounding factors, and Cox survival analysis was performed in the matched cohort. Subgroup analyses were conducted to evaluate population heterogeneity.</p><p><strong>Results: </strong>Among 19,796 patients who received mechanical ventilation, 10,073 (50.8%) initially received NIV. The analysis included 2935 matched pairs. Patients initially receiving NIV exhibited a higher survival rate (P = 0.009) and a 24% lower risk of in-hospital mortality compared to those initially receiving IMV (P < 0.001). Subgroup analysis indicated significant survival benefits with initial NIV for patients without malignant tumor (MT), or lower Sequential Organ Failure Assessment (SOFA) scores and higher PO₂/FiO₂.</p><p><strong>Conclusion: </strong>Among sepsis patients, initial NIV is linked to increased in-hospital survival rates and reduced mortality risk, particularly in patients without concurrent MT, lower SOFA scores, and higher PO₂/FiO₂.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"147"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762867","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":"Characteristics and sex differences in bronchopulmonary dysplasia-related pulmonary hypertension.","authors":"Dansha Zhou, Ting Wang, Yuqin Chen, Yulin Zheng, Yingzhen Zhou, Mingxiang Zhang, Aofeng Liu, Biao Hu, Shuang Fu, Ruixian Wu, Wei Chen, Xiaoli Jiang, Zehui Ye, Yuan Shi, Zhou Fu, Jian Wang","doi":"10.1186/s12890-025-03585-1","DOIUrl":"10.1186/s12890-025-03585-1","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) secondary to bronchopulmonary dysplasia (BPD) is associated with increased mortality. This study aims to elucidate the risk factors for BPD-PH development and the long-term prognostic factors in pediatric BPD.</p><p><strong>Methods: </strong>We analyzed 1082 BPD patients under the age of three. Univariate and multivariate regression were performed to determine the final model. Risk stratification was performed based on the predicted risk score, and Kaplan-Meier survival curves were used to compare survival rates.</p><p><strong>Results: </strong>The in-hospital mortality rate of severe BPD was three times than non-severe BPD, and pediatric BPD-PH had twice the mortality compared to BPD without PH. The incidence of BPD was 1.7 times higher in males, but there were no sex-specific differences in BPD severity. However, female children with BPD had a higher likelihood of developing BPD-PH and lower survival rates. Females, severity of BPD, congenital diaphragmatic hernia, ventricular septal defect, patent ductus arteriosus, uric acid, aspartate aminotransferase/alanine transaminase (ALT), and albumin were independent factors of PH in BPD. Severity of BPD, PH, severe pneumonia, budesonide use, use of adrenaline or noradrenaline, ALT, and day of respiratory support were independent factors for overall survival in pediatric BPD. Two web servers were constructed based on these predictive factors for risk prediction of BPD-PH ( https://sex-ph.shinyapps.io/Nomapp1/ ) and overall survival prediction in BPD patients ( https://zds88.shinyapps.io/DynNomapp/ ).</p><p><strong>Conclusion: </strong>This study confirmed sex differences in BPD-PH and emphasized the role of sex in the development and prognosis of the disease. Two web servers predicted personalized PH risk and survival outcomes in BPD.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"148"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762856","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 impact of frailty on clinical outcomes among individuals with COPD: a systematic review and meta-analysis.","authors":"Mathew Cherian, Pourya Masoudian, Kednapa Thavorn, Jacqueline Sandoz, Risa Shorr, Sunita Mulpuru","doi":"10.1186/s12890-025-03595-z","DOIUrl":"10.1186/s12890-025-03595-z","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a prevalent and robust predictor of poor outcomes for older adults and those with chronic disease. We performed a systematic review and meta-analysis of the literature to understand the association between frailty and clinical outcomes for people with COPD.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, Cochrane Central, CINAHL, and Web of Science from inception to February 2022, for observational studies evaluating the association between frailty and clinical outcomes among individuals with COPD. Included studies defined COPD by spirometry, used a validated frailty assessment tool, and compared dyspnea, symptom burden, health related quality of life, exacerbations, hospitalization, or mortality between frail and non-frail individuals. Risk of bias was assessed using the Newcastle Ottawa Scale. Mean differences or hazard ratios were calculated using inverse variance (IV) methods, odds ratios were calculated using Mantel-Haenszel methods, and homogeneity was assessed using I ² statistics. Results were pooled using a random effects model.</p><p><strong>Results: </strong>Of 1385 identified studies, 16 studies were included with 7 studies included in the meta-analyses, representing 5903 individuals. The Fried Frailty Phenotype instrument was used in 50% of included studies. When comparing frail vs. non-frail people with COPD, pooled estimates revealed frail people with COPD had higher dyspnea scores [modified Medical Research Council (mMRC) score standardized mean difference (95% CI): 1.67 (1.40-1.92), I ² = 24%]; higher symptom burden [COPD Assessment Test (CAT) score mean difference (95% CI): 10.24 (8.30-12.17), I ² = 31%]; more COPD exacerbations in the prior year [mean difference (95% CI): 1.09 (0.62-1.56), I ² = 0%), and increased odds of being hospitalized in the previous year [OR (95% CI): 2.94 (1.57-5.50); I ² = 0%]. The largest study with longest follow up period showed increased mortality risk among frail vs. non-frail individuals with COPD, [HR (95% CI): 1.83 (1.24-2.68)].</p><p><strong>Conclusions: </strong>People with COPD and frailty experience increased dyspnea, symptom burden, exacerbation history, and hospitalizations compared to non-frail patients with COPD. Frailty is a robust predictor of outcomes among people with COPD and should be considered a treatable trait. Additional work is needed to standardize screening methods for frailty, and to understand the optimal timing of non-pharmacologic interventions to treat frailty among people with COPD.</p><p><strong>Prospero registry id: </strong>CRD42022329893.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"146"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751120","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}