慢性阻塞性肺疾病和哮喘生理评分对COPD急性加重患者住院和1年死亡率的预测作用

IF 2.1 4区医学 Q3 RESPIRATORY SYSTEM

Canadian respiratory journal Pub Date : 2022-04-25 DOI:10.1155/2022/4110562

Z. Zeng, Qin Liu, Xiaoying Huang, Chu-Hsueh Lu, Juan Cheng, Yuqun Li, G. Hu, Liping Wei

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Results. 240 patients were enrolled in our study; 18 patients died during hospitalization and 29 patients died during the 1-year follow-up. Compared with in-hospital survivors, those who died were older (80.83 ± 6.06 vs. 76.94 ± 8.30 years old, P = 0.019) and had a higher percentage of congestive heart failure (61.1% vs. 14.4%, P < 0.001), higher CAPS levels (31.11 ± 10.05 vs. 16.49 ± 7.11 points, P < 0.001), and a lower BMI (19.48 ± 3.26 vs. 21.50 ± 3.86, P = 0.032). The area under the ROC curve of CAPS for in-hospital death was 0.91 (95% CI: 0.85–0.96) with a sensitivity of 0.889 and a specificity of 0.802 for a cut-off point of 21 points. CAPS ≥21 points was an independent risk factor for in-hospital mortality after adjustment for relative risk (RR) (RR = 13.28, 95% CI: 1.97–89.53, P = 0.008). Univariate Cox regression analysis showed that a CAPS ≥21 points (HR = 4.07, 95% CI: 1.97–8.44) was a risk factor for 1-year mortality. 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引用次数: 1

摘要

背景和目的：慢性阻塞性肺病（AECOPD）的急性加重往往导致高死亡率。慢性阻塞性肺病和哮喘生理学评分（CAPS）是一种简单的临床严重程度评分。本研究的目的是探讨CAPS是否可以有效预测AECOPD患者的住院和1年死亡率。方法。我们使用CAPS对所有患者进行评分并记录他们的临床特征。受试者-操作者特征（ROC）曲线用于确定区分幸存者和非幸存者的CAPS的截止值。单变量和多变量逻辑回归分析以及Cox回归分析分别用于确定住院和1年死亡率的风险因素。后果240名患者参与了我们的研究；18名患者在住院期间死亡，29名患者在1年随访期间死亡。与住院幸存者相比，死亡者年龄更大（80.83 ± 6.06对76.94 ± 8.30岁，P = 0.019），充血性心力衰竭的发生率较高（61.1%对14.4%，P < 0.001），CAPS水平较高（31.11 ± 10.05对16.49 ± 7.11分，P < 0.001）和较低的BMI（19.48 ± 3.26对21.50 ± 3.86，P = 0.032）。CAPS的ROC曲线下住院死亡面积为0.91（95%CI:0.85-0.96），敏感性为0.889，特异性为0.802，临界点为21点。CAPS≥21分是校正相对风险（RR）后住院死亡率的独立危险因素 = 13.28，95%置信区间：1.97–89.53，P = 0.008）。单变量Cox回归分析显示CAPS≥21分（HR = 4.07,95%可信区间：1.97-8.44）是1年死亡率的危险因素。然而，多元Cox回归分析显示CAPS（HR = 2.24，95%CI:0.90-5.53）与1年死亡率无关。结论：CAPS≥21分是AECOPD患者住院死亡率的一个强大而独立的危险因素，CAPS对COPD急性加重患者出院后1年的死亡率没有影响。

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Prognostic Role of Chronic Obstructive Pulmonary Disease and Asthma Physiology Score for in-Hospital and 1-year Mortality in Patients with Acute Exacerbations of COPD

Background and Objectives: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often lead to high mortality. Chronic obstructive pulmonary disease and asthma physiology score (CAPS) is a simple clinical severity score. The aim of this study was to explore whether CAPS could be an effective predictor for in-hospital and 1-year mortality in AECOPD patients. Methods. We used CAPS to grade all patients and record their clinical characteristics. The receiver operator characteristic (ROC) curve was used to determine the cut-off of CAPS that discriminated survivors and non-survivors. Univariate and multivariate logistic regression analyses and Cox regression analyses were used to identify the risk factors for in-hospital and 1-year mortality, respectively. Results. 240 patients were enrolled in our study; 18 patients died during hospitalization and 29 patients died during the 1-year follow-up. Compared with in-hospital survivors, those who died were older (80.83 ± 6.06 vs. 76.94 ± 8.30 years old, P = 0.019) and had a higher percentage of congestive heart failure (61.1% vs. 14.4%, P < 0.001), higher CAPS levels (31.11 ± 10.05 vs. 16.49 ± 7.11 points, P < 0.001), and a lower BMI (19.48 ± 3.26 vs. 21.50 ± 3.86, P = 0.032). The area under the ROC curve of CAPS for in-hospital death was 0.91 (95% CI: 0.85–0.96) with a sensitivity of 0.889 and a specificity of 0.802 for a cut-off point of 21 points. CAPS ≥21 points was an independent risk factor for in-hospital mortality after adjustment for relative risk (RR) (RR = 13.28, 95% CI: 1.97–89.53, P = 0.008). Univariate Cox regression analysis showed that a CAPS ≥21 points (HR = 4.07, 95% CI: 1.97–8.44) was a risk factor for 1-year mortality. However, multivariate Cox regression analysis showed that CAPS (HR = 2.24, 95% CI: 0.90–5.53) was not associated with 1-year mortality. Conclusion: A CAPS ≥21 points was a strong and independent risk factor for in-hospital mortality in AECOPD patients and CAPS had no impact on the 1-year mortality in patients with acute exacerbations of COPD after discharge.

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来源期刊

Canadian respiratory journal 医学-呼吸系统

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.