scholarly journals A Prediction Model for Intermediate- and High-risk Pulmonary Hypertension During the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Xilian Feng ◽  
Jiahua Liang ◽  
Jiamin Chen ◽  
Weiyan Chen ◽  
Hui Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Prediction Model ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Clinical Efficacy ◽  
Chronic Obstructive ◽  
Discriminative Ability ◽  
Obstructive Pulmonary Disease

Abstract Background: Pulmonary hypertension (PH) is a serious complication of COPD and is associated with poor prognosis. There are currently no established predictive models for PH during the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Objective: To establish a prediction model for intermediate- and high-risk PH in AECOPD patients.Methods: This study collected data from 203 AECOPD patients and divided the patients into a model group and an external validation group. The influence of each parameter on PH was analysed through univariate and multivariate analyses, and these data were used to build a prediction model. Finally, the discriminative ability, calibration ability and clinical efficacy of the model were tested.Result: Age, RDW-CV and RDW-SD were related to PH, so these variables were used to establish a prediction model. In addition, the discriminative ability, calibration ability and clinical efficacy of the model were affirmed.Conclusion: This study established a clinical prediction model for AECOPD patients with PH, and the prediction model has certain clinical value for assisting in the screening of intermediate- and high-risk patients with PH.

scholarly journals Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Vol 14 ◽  
pp. 175346662096168
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong-Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.

scholarly journals Predictive Value of Novel Inflammation-Based Biomarkers for Pulmonary Hypertension in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Huanhuan Zuo ◽  
Xiaochen Xie ◽  
Jiahuan Peng ◽  
Lixin Wang ◽  
Rong Zhu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Univariate Analysis ◽  
Systolic Pressure ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lymphocyte Ratio

Recently, there has been an increasing interest in the potential clinical use of several inflammatory indexes, namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic-immune-inflammation index (SII). This study aimed at assessing whether these markers could be early indicators of pulmonary hypertension (PH) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 185 patients were enrolled in our retrospective study from January 2017 to January 2019. Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate the clinical significance of these biomarkers to predict PH in patients with AECOPD. According to the diagnostic criterion for PH by Doppler echocardiography, the patients were stratified into two groups. The study group consisted of 101 patients complicated with PH, and the control group had 84 patients. The NLR, PLR, and SII values of the PH group were significantly higher than those of the AECOPD one (p<0.05). The blood biomarker levels were positively correlated with NT-proBNP levels, while they had no significant correlation with the estimated pulmonary arterial systolic pressure (PASP) other than PLR. NLR, PLR, and SII values were all associated with PH (p<0.05) in the univariate analysis, but not in the multivariate analysis. The AUC of NLR used for predicting PH was 0.701 and was higher than PLR and SII. Using 4.659 as the cut-off value of NLR, the sensitivity was 81.2%, and the specificity was 59.5%. In conclusion, these simple markers may be useful in the prediction of PH in patients with AECOPD.

scholarly journals Association of brain natriuretic peptide gene polymorphisms with chronic obstructive pulmonary disease complicated with pulmonary hypertension and its mechanism

2018 ◽  
Vol 38 (5) ◽  
Author(s):  
Guangjun Jin ◽  
Zhu Chen ◽  
Jiancheng Zhang ◽  
Jia Song ◽  
Jun Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Brain Natriuretic Peptide ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Protein Levels ◽  
High Risk Factors

Objective: To examine the association between brain natriuretic peptide (BNP) gene single nucleotide polymorphisms (SNPs) and chronic obstructive pulmonary disease (COPD) and COPD with pulmonary hypertension (PH) and to analyze its mechanism. Methods: The genotypes of BNP at the rs198389, rs6668352, and rs198388 loci in 339 patients with COPD (205 in the COPD/PH− group and 134 in the COPD/PH+ group) and 125 healthy subjects were detected by PCR/Sanger sequencing. The serum levels of BNP, fibrinogen (Fbg), and Apelin were measured in all subjects by ELISA. Results: The BNP rs198389 locus G allele, rs6668352 locus A allele, and 198388 locus T allele were high risk factors for COPD (P<0.001). Logistics regression analysis showed that BNP rs198389 locus G allele, rs6668352 locus A allele, and rs198388 locus T allele were high risk factors for PH in COPD patients (all P<0.001). The levels of the serum BNP and Fbg protein in the control group, COPD/PH− group, and COPD/PH+ group increased successively, and the expression levels of Apelin protein decreased successively (all P<0.001). The BNP and Fbg protein levels in the wild-type, heterozygote, and mutant homozygote in BNP rs198389, rs6668352, and rs198388 loci increased successively, and the serum Apelin protein levels decreased successively (all P<0.001). Conclusion: The polymorphisms of BNP at the rs198389, rs6668352, and rs198388 loci are associated with the occurrence of COPD and COPD with PH, and the occurrence may be related to the abnormal expression level of BNP, Fbg, and Apelin protein in the serum.

Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Comorbid Condition ◽  
Obstructive Pulmonary Disease

Abstract Background Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods We included 16,105 patients who had claimed their medical expenses from May 1, 2014, to May 1, 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%) and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities, and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusions Readmission occurred in approximately a quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge and development and evaluation of an effective care programs for COPD patients are necessary.

scholarly journals Effect of Lianhuaqingwen Capsules on Airway Inflammation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Liang Dong ◽  
Jing-wen Xia ◽  
Yi Gong ◽  
Zhen Chen ◽  
Hai-hua Yang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Airway Inflammation ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Western Medicine ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Inflammatory Response ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is characterized by a chronic inflammatory response that is worsened by acute exacerbations. Lianhuaqingwen (LHQW) has anti-inflammatory and immune regulatory functions and may inhibit the airway inflammation that occurs during an acute exacerbation of COPD. In this study, 100 participants were recruited and randomly assigned, 1 : 1, to the LHQW and the conventional groups, which were treated, respectively, with LHQW capsules and conventional Western medicine or only conventional Western medicine. The scores of the CAT scale and levels of inflammatory cytokines in blood and sputum were measured during treatment. In addition, subjects were subdivided into high-risk and low-risk subgroups. The CAT scores in the LHQW group and high-risk subgroup were clearly improved from the 5th day, but the other groups improved only after treatment was completed. Expression levels of IL-8, TNF-α, IL-17, and IL-23 in the sputum and of IL-8 and IL-17 in the blood were significantly decreased after treatment, and similar results were found in subgroups. These data suggested that LHQW capsules can accelerate the improvement of AECOPD patients, especially for the high-risk subgroup, and the mechanism of action may be related to the decreased release of inflammatory mediators.

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