Effect of nutritional risk on cognitive function in patients with chronic obstructive pulmonary disease

Objective We aimed to clarify the cognitive function of patients with chronic obstructive pulmonary disease (COPD) and different nutritional status. Methods Among 95 patients with COPD in this retrospective study, we administered the Nutritional Risk Screening 2002 (NRS 2002) and Mini-Mental State Examination (MMSE). We recorded patients’ clinical characteristics, comorbidities, and laboratory measurements. According to NRS 2002 scores, patients were divided into two groups: no nutritional risk with NRS 2002 < 3 ( n = 54) and nutritional risk, with NRS 2002 ≥ 3 ( n = 41). Results We found a negative correlation between NRS 2002 and MMSE scores in participants with COPD ( r = −0.313). Patients with nutritional risk were more likely to be cognitively impaired than those with no nutritional risk. Multivariate logistic regression analysis indicated that malnutrition was an independent risk factor for cognitive impairment, after adjusting for confounders (odds ratio [OR] = 4.120, 95% confidence interval [CI]: 1.072–15.837). We found a similar association between NRS 2002 and MMSE scores at 90-day follow-up using a Pearson’s correlation test ( r = −0.493) and logistic regression analysis (OR = 7.333, 95% CI: 1.114–48.264). Conclusions Patients with COPD at nutritional risk are more likely to have cognitive impairment.

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Risk Factors and Outcomes Associated with Chronic Obstructive Pulmonary Disease Exacerbations Requiring Hospitalization

Canadian Respiratory Journal ◽

10.1155/2009/179263 ◽

2009 ◽

Vol 16 (4) ◽

pp. e43-e49 ◽

Cited By ~ 27

Author(s):

Katayoun Bahadori ◽

J Mark FitzGerald ◽

Robert D Levy ◽

Tharwat Fera ◽

John Swiston

Keyword(s):

Risk Factors ◽

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Pulmonary Disease ◽

Logistic Regression Analysis ◽

Hospital Readmission ◽

Chronic Obstructive ◽

Readmission Rates ◽

Obstructive Pulmonary Disease

BACKGROUND: Acute respiratory exacerbations are the most frequent cause of medical visits, hospitalization and death for chronic obstructive pulmonary disease (COPD) patients and, thus, exert a significant social and economic burden on society.OBJECTIVE: To identify the risk factors associated with hospital readmission(s) for acute exacerbation(s) of COPD (AECOPD).METHODS: A review of admission records from three large urban hospitals in Vancouver, British Columbia, identified 310 consecutive patients admitted for an AECOPD between April 1, 2001, and December 31, 2002. Logistic regression analysis was performed to identify risk factors for readmissions following an AECOPD.RESULTS: During the study period, 38% of subjects were readmitted at least once. The mean (± SD) duration from the index admission to the first readmission was 5±4.08 months. Comparative analysis among the three hospitals identified a significant difference in readmission rates (54%, 36% and 18%, respectively). Logistic regression analysis revealed that preadmission home oxygen use (OR 2.55; 95%CI 1.45 to 4.42; P=0.001), history of a lung infection within the previous year (OR 1.73; 95% CI 1.01 to 2.97; P=0.048), other chronic respiratory disease (OR 1.78; 95% CI 1.06 to 2.99; P=0.03) and shorter length of hospital stay (OR 0.97; 95% CI 0.945 to 0.995; P=0.021) were independently associated with frequent readmissions for an AECOPD.CONCLUSIONS: Hospital readmission rates for AECOPD were high. Only four clinical factors were found to be independently associated with COPD readmission. There was significant variability in the readmission rate among hospitals. This variability may be a result of differences in the patient populations that each hospital serves or may reflect variability in health care delivery at different institutions.

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A new tool for predicting in-hospital mortality in Chinese older patients with exacerbation of chronic obstructive pulmonary disease(AECOPD): frailty index based on common laboratory tests (FI-Lab)

10.21203/rs.3.rs-121756/v1 ◽

2020 ◽

Author(s):

Jinjin Gu ◽

Lijie Zheng ◽

Qiang Liu

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Hospital Mortality ◽

Pulmonary Disease ◽

Roc Curves ◽

Youden Index ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

The Mean

Abstract Introduction: The exacerbation of chronic obstructive pulmonary disease(AECOPD)is a common and fetal disease but with no ideal predictor of in-hospital mortality. Frailty prevails in older adults with AECOPD and can cause increased vulnerability to many adverse health outcomes including death. However, we know little about how frailty affects in-hospital mortality in older AECOPD patients. Objective: To explore the predictive validity of FI-Lab—an objective tool for assessing frailty including 21 routine blood tests plus systolic and diastolic blood pressure (a score between 0 and 1, a higher score indicates greater frailty)—for in-hospital mortality in patients with AECOPD. Methods: We reviewed the hospitalization records of older AECOPD inpatients from September 2016 to June 2019 at Zhenjiang First People's Hospital. We compared survivors to non-survivors. We used propensity score matching (PSM) to balance priori differences between survivors and non-survivors. Logistic regression analysis was used to select the associated predictors of in-hospital mortality. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curve (AUCs) for FI-Lab and DECAF(a commonly used predictor of AECOPD including dyspnea, eosinophilia, pulmonary consolidation, acidemia, and atrial fibrillation; a score between 1and 6; a higher score indicates poorer condition)in relation to mortality. Data were analyzed using IBM SPSS for Windows, Version 23.0. Results: A total of 154 patients—77 survivors and 77 non-survivors—were included in the study finally. The mean age of these patients was 79.73 ± 8.38 years. Both of the mean DECAF score, the mean FI-Lab value of non-survivors were statistically higher than those of survivors(4.45 ± 0.80 versus 3.03 ± 0.90,P = 0.000; 0.51 ± 0.13 versus 0.29 ± 0.10,P = 0.000,respectively). Logistic regression analysis suggested that high DECAF grade and high FI-Lab grade were strong related factors of death in AECOPD patients (OR:5.620, 95%CI 2.811–11.236, P = 0.000; OR:8.705, 95%CI 3.646–20.782, P = 0.000, respectively). The DECAF scores of most non-survivors were ≥ 4༈n = 71,92.21%༉. FI-Lab value predicted in-hospital mortality at a cut-off value of 0.4388 with 70.1% sensitivity, 96.1% specificity, 0.675 Youden index. DECAF score predicted in-hospital mortality at a cut-off value of 3.5 with 92.2% sensitivity, 72.7% specificity, 0.649 Youden index. The areas under the ROC curves were 0.906 for FI-Lab and 0.870 for DECAF with no statistically significant༈P = 0.2991). Conclusions: FI-Lab has a slightly stronger screening ability than DECAF. FI-Lab is a simple, effective and objective indicator and can be quick to help clinicians to assess in-hospital mortality of AECOPD patients.

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Effects of Glutathione S-Transferase Gene Polymorphisms and Antioxidant Capacity per Unit Albumin on the Pathogenesis of Chronic Obstructive Pulmonary Disease

Oxidative Medicine and Cellular Longevity ◽

10.1155/2017/6232397 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Tinghui Cao ◽

Naijin Xu ◽

Zhen Wang ◽

Hui Liu

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Antioxidant Capacity ◽

Pulmonary Disease ◽

Gene Polymorphisms ◽

Chronic Obstructive ◽

Control Groups ◽

Obstructive Pulmonary Disease ◽

And Control

Objectives. To study the effects of GSTM1, GSTT1 gene polymorphisms, and organism antioxidant capacity and related indicators such as antioxidant capacity per unit of albumin (AC/ALB) on chronic obstructive pulmonary disease (COPD). Methods. Using polymerase chain reaction technology, GSTM1 and GSTT1 gene polymorphisms were detected in 33 COPD patients and 33 healthy people. The total antioxidant capacity (TAC) found in serum was determined using the I2/KI potentiometric, KMnO4 microtitration, and H2O2 potentiometric methods. The AC/ALB was defined as the TAC divided by the serum albumin concentration. Logistic regression analysis was carried out with biochemical screening indices, which was found to be closely related with the incidence of COPD. Results. The GSTM1 and GSTT1 gene deletion rate in the COPD group was significantly higher than that in the control group (P<0.05). The differences in serum TAC between the COPD and control groups, GSTM1 (+) and GSTM1 (−) groups, and GSTT1 (+) and GSTT1 (−) groups were statistically significant (P<0.001). In addition, there was a significant difference in the AC/ALB between the COPD and control groups (P<0.05). Logistic regression analysis showed that the incidence of COPD was closely related to the AC/ALB (P<0.05). Conclusions. GSTM1 and GSTT1 gene polymorphisms are closely correlated with the pathogenesis of COPD, while the AC/ALB plays a decisive role in the occurrence and development of COPD.

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Asthma Patients Benefit More Than Chronic Obstructive Pulmonary Disease Patients in the Coronavirus Disease 2019 Pandemic

Frontiers in Medicine ◽

10.3389/fmed.2021.709006 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ruoyan Xiong ◽

Zhiqi Zhao ◽

Huanhuan Lu ◽

Yiming Ma ◽

Huihui Zeng ◽

...

Keyword(s):

Risk Factors ◽

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Pulmonary Disease ◽

Logistic Regression Analysis ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Asthma Patients

Background: Coronavirus disease 2019 (COVID-19) has raised many questions about the role of underlying chronic diseases on disease outcomes. However, there is limited information about the effects of COVID-19 on chronic airway diseases. Therefore, we conducted the present study to investigate the impact of COVID-19 on patients with asthma or chronic obstructive pulmonary disease (COPD) and ascertain risk factors for acute exacerbations (AEs).Methods: This single-center observational study was conducted at the Second Xiangya Hospital of Central South University, involving asthma or COPD patients who had been treated with inhaled combination corticosteroids (ICSs), such as budesonide, and one long-acting beta-2-agonist (LABA), such as formoterol, for at least a year before the COVID-19 pandemic. We conducted telephone interviews to collect demographic information and clinical data between January 1, 2019, and December 31, 2020, focusing on respiratory and systemic symptoms, as well as times of exacerbations. Data for asthma and COPD were then compared, and the risk factors for AEs were identified using logistic regression analysis.Results: A total of 251 patients were enrolled, comprising 162 (64.5%) who had asthma and 89 who had COPD, with none having COPD/asthma overlap. Frequency of AEs among asthma patients was significantly lower in 2020 than in 2019 (0.82 ± 3.33 vs. 1.00 ± 3.16; P < 0.05). Moreover, these patients visited the clinic less (0.37 ± 0.93 vs. 0.49 ± 0.94; P < 0.05) and used emergency drugs less (0.01 ± 0.11 vs. 007 ± 0.38; P < 0.05) during the COVID-19 pandemic. In contrast, among COPD patients, there were no significant differences in AE frequency, clinic visits, or emergency drug use. Furthermore, asthma patients visited clinics less frequently during the pandemic than those with COPD. Logistic regression analysis also showed that a history of at least one AE within the last 12 months was associated with increased AE odds for both asthma and COPD during the COVID-19 pandemic (odds ratio: 13.73, 95% CI: 7.04–26.77; P < 0.01).Conclusion: During the COVID-19 pandemic, patients with asthma showed better disease control than before, whereas patients with COPD may not have benefited from the pandemic. For both diseases, at least one AE within the previous 12 months was a risk factor for AEs during the pandemic. Particularly, among asthma patients, the risk factors for AE during the COVID-19 pandemic were urban environment, smoking, and lower asthma control test scores.

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Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

The Heart Surgery Forum ◽

10.1532/hsf.868 ◽

2005 ◽

Vol 6 (5) ◽

pp. 348 ◽

Cited By ~ 5

Author(s):

A. Kramer ◽

R. Mohr ◽

O. Lev-Ran ◽

R. Braunstein ◽

D. Pevni ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Regression Analysis ◽

Pulmonary Disease ◽

Internal Thoracic Artery ◽

Chronic Obstructive ◽

Midterm Results ◽

Obstructive Pulmonary Disease ◽

Sternal Infection ◽

Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

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