保加利亚患者严重COPD加重后的两年死亡率

Q4 Medicine
E. Mekov, R. Petkov, A. Tsakova, M. Genova, D. Kostadinov
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引用次数: 0

摘要

摘要COPD患者的两年死亡率预计在10%至49%之间,这取决于所调查的亚组和特定患者的特征。目的:评估COPD患者因严重急性加重住院后的两年死亡率,并描述合并症和特定患者特征的预后价值。材料和方法:我们纳入了152名因COPD恶化住院并签署知情同意书的连续患者。代谢综合征(MS)、糖尿病(DM)和维生素D缺乏症是根据国际指南诊断的。记录人口统计学参数(年龄、性别、吸烟状况和包装年数)。使用CAT和mMRC问卷调查生活质量。肺功能通过肺活量测定法进行评估。两年死亡率是根据从国家死亡登记册中提取的数据确定的。结果:两年死亡率为11.8%。所调查的合并症——糖尿病、多发性硬化症、动脉高压(AH)和维生素D状态并不能预测两年死亡率。mMRC≥2(17.2 vs.1.9%,p=0.005)和CAT评分≥10(14.2 vs.0%,p=0.045)的患者死亡率增加。前一年的严重恶化是登记的两年死亡率的危险因素(17.5%vs.5.6%,p=0.021)。FEV1<50%的组两年死亡率增加,Cox回归分析显示,FEV1每降低1%,死亡率增加3.0%,PEF每降低1%死亡率增加6.2%,年龄增加一年死亡率增加7.8%,FEV1/FVC比值降低1%时为4%,CAT每升高1点时为7.1%(p值均<0.05)。结论:COPD患者严重加重后的两年死亡率相对较低。按时间顺序排列的年龄、FEV1、前一年的严重恶化史、生活质量下降和低BMI都与死亡率增加有关。疾病等级C、mMRC<2和CAT评分<10与良好的预后相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Two-Year Mortality Following a Severe COPD Exacerbation in Bulgarian Patients
Abstract Two-year mortality in patients with COPD is expected to be between 10% and 49% depending on the investigated subgroup and specific patients’ characteristics. Aim: To assess the two-year mortality in COPD patients following hospitalization for severe exacerbation and to describe the prognostic value of comorbidities and specific patients’ characteristics. Materials and methods: We included 152 consecutive patients hospitalized for COPD exacerbation and signing informed consent. The Metabolic syndrome (MS), diabetes mellitus (DM), and hypovitaminosis D were diagnosed according to international guidelines. Demographic parameters (age, sex, smoking status, and the number of pack-years) were recorded. Quality of life was examined using CAT and mMRC questionnaires. The lung function was assessed by spirometry. Two-year mortality was determined according to data extracted from the national death register. Results: Two-year mortality rate was 11.8%. The investigated comorbidities – DM, MS, arterial hyper-tension (AH) and vitamin D status were no predictors of the two-year mortality. Mortality was increased in patients with mMRC ≥ 2 (17.2 vs. 1.9%, p = 0.005) and CAT score ≥ 10 (14.2 vs. 0%, p = 0.045). Severe exacerbation during the previous year was a risk factor for the registered two-year mortality (17.5% vs 5.6%, p = 0.021). The two-year mortality was increased in the group with FEV1 < 50%, compared to FEV1 > 50% (18.0 vs. 7.7%, p = 0.049). Cox regression analysis showed a 3.0% increase in the mortality rate for each 1% decrease in FEV1, 6.2% for each 1% decrease in PEF, 7.8% for one year of increasing age, 4% for 1% decrease in the FEV1/FVC ratio and 7.1% for each 1 point increase of CAT (all p-values < 0.05). Conclusions: The two-year mortality of COPD patients following a severe exacerbation was relatively low. Chronological age, FEV1, history for severe exacerbation during the previous year, reduced quality of life, and low BMI were all associated with increased mortality. Disease Grade C, mMRC < 2, and CAT score < 10 were associated with a favourable prognosis.
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来源期刊
Acta Medica Bulgarica
Acta Medica Bulgarica Medicine-Medicine (all)
CiteScore
0.30
自引率
0.00%
发文量
33
审稿时长
25 weeks
期刊介绍: About 30 years ago - in 1973, on the initiative of the Publishing House „Medicine and Physical Culture", namely its former director Mr. Traian Ivanov, the Ministry of Health set up and accepted to subsidize a new medical magazine that was to be published only in the English language and had to reflect the status and the achievements of the Bulgarian medical science. Thus the language barrier was overcome and stable relations were established with the international medical society, large libraries, and university centers. The famous internationally known scientist professor Assen A. Hadjiolov was elected edition-in-chief by the first editorial staff and the magazine was named Acta Medica Bulgarica.
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