Comparison of High-Sensitive CRP, RDW, PLR and NLR between Patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

2021 ◽  
Vol 17 ◽  
Author(s):  
Mehrdad Solooki ◽  
Mohammad Parsa Mahjoob ◽  
Razieh Sadat Mousavi-roknabadi ◽  
Meghdad Sedaghat ◽  
Mohammad Rezaeisadrabadi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Stay ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
Hscrp Level ◽  
Obstructive Pulmonary Disease ◽  
Walking Test ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
History Of

Background: Chronic obstructive pulmonary disease (COPD) is a chronic systemic inflammation, which has similar signs and symptoms to chronic heart failure (CHF). Objective: To compare high-sensitive C-reactive protein (hsCRP) level and selected blood indices in patients with COPD and CHF. Methods: This prospective cross-sectional study (July 2019-July 2020) was conducted on patients aged 40-70 years old with a previous diagnosis of COPD, CHF, and cor pulmonale. They were divided into four groups: 1) patients with COPD, who were hospitalized due to exacerbation of dyspnea, 2) patients with CHF without a history of COPD, 3) patients with CHF and history of COPD (COPD+CHF), and finally 4) patients who had concomitant COPD and cor pulmonale condition. Spirometry, echocardiography, and six-minute walking test were performed. The hsCRP level was assessed at the beginning and end of hospital admission. Finally, RDW, neutrophil, lymphocyte, platelet counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were measured. Data were analyzed by SPSS software (α = 0.05). Results: In total, 140 patients were enrolled. The highest hsCRP level was observed in patients in the COPD+CHF group, and the lowest level was found in patients with CHF. Overall, a significant difference was observed in the hsCRP level at the beginning and the end of admission (P <0.0001). HsCRP had a positive correlation with the duration of hospital stay and a negative correlation with the results of the six-minute walking test. The lymphocyte counts and PLR had significant positive correlations with the six-minute walking test (R =0.38, P <0.0001 vs. R =0.325, P =0.001, respectively), and significant negative correlations with duration of hospital stay (R =-0.317, P <0.0001 vs. R =-0.380, P =0.001, respectively). At the admission, a significant difference in hsCRP was only observed comparing the COPD and cor pulmonale groups (OR =1.097, P =0.002). There were significant differences in the six-minute walking test comparing the COPD group with either of CHF or COPD+CHF groups. Significant differences were noted in the hospital stay duration comparing the COPD group with all other groups. Conclusion: The results of this study showed that lymphocyte, neutrophil, platelets counts, as well as RDW, NLR, and PLR indices, were not useful for differentiating COPD from CHF. However, the hsCRP level may help in differentiating COPD from patients with cor pulmonale.

scholarly journals Analysis of the effect of proton pump inhibitors on the course of common COVID-19

2020 ◽  
Author(s):  
Xiao-Yu Zhang ◽  
Hai-Bing Wu ◽  
Yun Ling ◽  
Zhi-Ping Qian ◽  
Liang Chen
Keyword(s):  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cumulative Incidence ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Clinical Center ◽  
Significant Difference

ABSTRACTBackground/aimsTo evaluate the effect of proton pump inhibitors on the course of common COVID-19.MethodsClinical data of common COVID-19 patients admitted to the Shanghai public health clinical center for treatment from January 20, 2020 to March 16, 2020 were collected. A retrospective study was conducted and the patients were divided into two groups according to whether they used proton pump inhibitors or not. The differences in SARS-CoV-2 clearance and hospital stay between the two groups were compared by univariate and multivariate analyses.ResultsA total of 154 COVID-19 common cases were included in this study, including 80 males (51.9%), 35 patients (22.7%) in the proton pump inhibitors group, and 119 patients (77.3%) in the control group. In the proton pump inhibitors group and the control group, the duration of SARS-CoV-2 clearance were 7(6-9) and 7(6-11) days, and the duration of hospital stay was 21(16-25) and 20(15-26) days, respectively. There was no significant difference between the two groups in the cumulative incidence of SARS-CoV-2 clearance and the cumulative incidence of discharge, and the same after Propensity Score Match, all P > 0.05. Multivariate analysis suggested that chronic gastropathy prolonged the duration of SARS-CoV-2 clearance, the HR was 20.924(3.547-123.447). Hypertension, chronic obstructive pulmonary disease, chronic liver disease and malignant tumor all increased the duration of hospital stay for COVID-19, and the HR were 1.820 (1.073-3.085), 4.370 (1.205-15.844), 9.011 (2.681-30.290) and 5.270 (1.237-22.456), respectively; the duration of hospital stay in COVID-19 patients was shortened by SARS-CoV-2 clearance, and the HR was 0.907 (0.869-0.947); all P < 0.05.ConclusionProton pump inhibitors use have no effect on the prolonging or shortening of the course of adults hospitalized with COVID-19.

scholarly journals Analysis of the Effect of Proton Pump Inhibitors on the Course of Common COVID-19

2020 ◽  
Author(s):  
xiaoyu ZHANG ◽  
Haibing Wu ◽  
Yun Ling ◽  
Liang Chen
Keyword(s):  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Multivariate Analyses ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Clinical Center ◽  
Significant Difference

Abstract Background/aims: This study is to evaluate the effect of proton pump inhibitors on the course of common COVID-19.Methods: Clinical data of common COVID-19 patients admitted to the Shanghai Public Health Clinical Center for treatment from January 20, 2020 to March 16, 2020 were collected. A retrospective study was conducted and the patients were divided into two groups according to whether they used proton pump inhibitors or not. The differences in SARS-CoV-2 clearance and hospital stay between the two groups were compared by univariate and multivariate analyses.Results: A total of 154 COVID-19 common cases were included in this study, including 80 males (51.9%), 35 patients (22.7%) in the proton pump inhibitors group, and 119 patients (77.3%) in the control group. In the proton pump inhibitors group and the control group, the duration of the SARS-CoV-2 clearance were 7(6-9) and 7(6-11) days, and the duration of the hospital stay was 21(16-25) and 20(15-26) days, respectively. There was no significant difference between the two groups in the cumulative incidence of the SARS-CoV-2 clearance and the discharge, all P > 0.05. Multivariate analysis showed that chronic gastropathy prolonged the duration of SARS-CoV-2 clearance, the HR was 20.924(3.547-123.447). Hypertension, chronic obstructive pulmonary disease, chronic liver disease and malignant tumor all increased the duration of hospital stay for COVID-19, and the HR were 1.820 (1.073-3.085), 4.370 (1.205-15.844), 9.011 (2.681-30.290) and 5.270 (1.237-22.456), respectively; the duration of the hospital stay in COVID-19 patients was shortened by the SARS-CoV-2 clearance, and the HR was 0.907 (0.869-0.947); all P < 0.05.Conclusion: Proton pump inhibitors use has no effect on the prolonging or shortening of the course of adults hospitalized with COVID-19.

scholarly journals A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hikmet Topaloglu ◽  
Nihat Karakoyunlu ◽  
Sercan Sari ◽  
Hakki Ugur Ozok ◽  
Levent Sagnak ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Ureteral Stones ◽  
Surgical Equipment ◽  
Duration Of Hospital Stay ◽  
Stone Free Rate ◽  
Surgical Expertise ◽  
Significant Difference ◽  
History Of ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones.Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed.Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.;P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.;P=0.039).Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

scholarly journals Iron deficiency in non-anemic chronic obstructive pulmonary disease in a predominantly male population: an ignored entity

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Vidushi Rathi ◽  
Pranav Ish ◽  
Gulvir Singh ◽  
Mani Tiwari ◽  
Nitin Goel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Iron Deficiency ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Male Population ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Iron Deficient ◽  
Significant Difference

Non-anemic iron deficiency has been studied in heart failure, but studies are lacking in chronic obstructive pulmonary disease (COPD). The potential clinical implications of association of iron deficiency with the severity of COPD warrant research in this direction. This was an observational, cross-sectional study on patients with COPD to compare disease severity, functional status and quality of life in non-anemic patients with COPD between two groups - iron deficient and non-iron deficient. Stable non-anemic COPD with no cause of bleeding were evaluated for serum iron levels, ferritin levels, TIBC, 6MWD, SGRQ, spirometry, and CAT questionnaire. The study patients were divided into iron replete (IR) and iron deficient (ID) groups. A total of 79 patients were studied, out of which 72 were men and seven were women. The mean age was 61.5±8.42 years. Of these, 36 (45.5%; 95% CI, 34.3-56.8%) had iron deficiency. Mean 6-minute-walk distance was significantly shorter in ID (354.28±82.4 meters vs 432.5±47.21 meters; p=0.001). A number of exacerbations in a year were more in ID group (p=0.003), and more patients in ID had at least two exacerbations of COPD within a year (p=0.001). However, the resting pO2, SaO2, and SpO2 levels did not differ significantly between the two groups (p=0.15 and p=0.52, respectively). Also, there was no significant difference in the distribution of patients of a different class of airflow limitations between the two groups. Non-anemic iron deficiency (NAID) is an ignored, yet easily correctable comorbidity in COPD. Patients with iron deficiency have a more severe grade of COPD, had lesser exercise capacity and more exacerbations in a year as compared to non-iron deficient patients. So, foraying into the avenue of iron supplementation, which has shown promising results in improving functional capacity in heart failure and pulmonary hypertension, may well lead to revolutionary changes in the treatment of COPD.

scholarly journals Current Antibiotic Treatment and Outcome for Lower Respiratory Tract Infections

1998 ◽  
Vol 9 (suppl e) ◽  
pp. 30E-34E
Author(s):  
Alasdair P MacGowan ◽  
Tracey Halladay ◽  
Andrew M Lovering
Keyword(s):  
Respiratory Tract ◽  
Hospital Stay ◽  
Lower Respiratory Tract ◽  
Community Acquired Pneumonia ◽  
Economic Evaluations ◽  
Chronic Obstructive ◽  
National Guidelines ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Tract Infections

A number of national guidelines have been published to aid the antimicrobial management of community-acquired pneumonia. However, data on prescriptions for lower respiratory tract infection (LRTI) indicate considerable variation in the choice of first-line and subsequent therapy at national and local levels. Outcomes research in LRTI, whether based on clinical, economic or patient-focused criteria, is still evolving. Clinical outcomes are best studied for both pneumonia and exacerbation of chronic obstructive pulmonary disease. Economic evaluations often do not encompass all of the costs, for example, time off from work or the economic impact of antibacterial resistance. Duration of hospital stay is a good marker of costs for hospital providers and may be affected by age. marital status and comorbidities. Antibiotic choice may have an impact on the duration of hospital stay by increasing side effects, predisposing patients to hospitalacquired infection or reduced clinical efficacy. Patient expectation is largely unstudied in pulmonary infection.

The Case: A Son’s Refusal

2010 ◽  
Vol 19 (4) ◽  
pp. 530-530 ◽  
Author(s):  
J. WESTLY McGAUGHEY ◽  
REBECCA L. VOLPE
Keyword(s):  
Heart Failure ◽  
Gastric Tube ◽  
Chronic Obstructive ◽  
Intense Pain ◽  
Medical Decisions ◽  
Obstructive Pulmonary Disease ◽  
Eye Pain ◽  
The Past ◽  
History Of ◽  
Lateral Sclerosis

Mrs. J was a 66-year-old Muslima who was brought to the hospital from the subacute unit where she had been living for the past 2 years because of intense pain caused by keratitis, an inflamed cornea of a nonfunctioning eye. In addition to her severe eye pain, Mrs. J suffered with a number of other difficult medical conditions, including amyotrophic lateral sclerosis. She was both gastric tube and ventilator dependent and had a history of multiple myleoma, chronic obstructive pulmonary disease, and congestive heart failure. Mrs. J came from a large and traditional Muslim family with 6 children and 17 grandchildren. Although she had full decisionmaking capacity, she designated one of her sons to make her medical decisions for her.

Low-Dose Dopamine in Severe Right Heart Failure and Chronic Obstructive Pulmonary Disease

1995 ◽  
Vol 29 (5) ◽  
pp. 493-496 ◽  
Author(s):  
Thomas YK Chan
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Cardiac Output ◽  
Low Dose ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Dopamine Infusion ◽  
Beneficial Effects ◽  
Diuretic Response

Objective: To describe the beneficial effects of low-dose dopamine infusion (2-5 μg/kg/min) in a patient with severe cor pulmonale complicating chronic obstructive pulmonary disease (COPD). Case Summary: A 53-year-old woman with severe cor pulmonale and generalized edema complicating COPD received low-dose dopamine to stabilize blood pressure and, perhaps, improve cardiac output. Low-dose dopamine also improved her renal function and enhanced the diuretic response to furosemide therapy. Discussion: Previous studies of dopamine in such patients were reviewed. Both dopamine infusion (4 μg/kg/min) and oral administration of its precursor, l-dopa, can increase the cardiac output, decrease pulmonary vascular resistance, and enhance oxygen delivery in patients who are stable with cor pulmonale secondary to COPD. In patients with COPD during acute respiratory failure, high-dose dopamine (10 μg/kg/min) has been shown to increase the diaphragmatic blood flow and contraction. Low-dose dopamine also has been reported to be useful in patients with congestive heart failure or cirrhosis of the liver. Conclusions: Low-dose dopamine is useful in the acute management of patients with severe cor pulmonale complicating COPD because of the drug's beneficial effects on blood pressure, cardiac output, renal perfusion, natriuresis, and diuresis. Low-dose dopamine also may enhance the natriuretic and diuretic response to loop diuretics, decrease pulmonary vascular resistance, and enhance oxygen delivery.

scholarly journals Echocardiographic Evaluation of Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
pp. 55-61
Author(s):  
Shishirakumar A. Goudar ◽  
Virendra Chandrashekhar Patil
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inverse Correlation ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
Two Dimensional ◽  
Obstructive Pulmonary Disease ◽  
Doppler Study ◽  
Significant Difference ◽  
Severity Of The Disease

There is an overlap of risk factors between heart disease and COPD like cigarette smoking, sedentary lifestyle and old age. The economic burden of COPD is also very high. It is now proven that the only strategy which can reduce COPD incidence is cessation of smoking. The Aim of the present research is to study the Two-dimensional transthoracic Echocardiography (TTE) findings in patients with chronic obstructive pulmonary disease (COPD).The method is that all the enrolled patients were subjected to chest radiography, pulmonary function test, Two-dimensional transthoracic echocardiogram and Doppler study, according to the standard protocol. The findings in our study are consistent with previous studies about the COPD. Total 111(60.7%) of the patients had echocardiographic evidence of pulmonary hypertension and 83(45.4%) of the patients in this study had evidence of cor pulmonale.  We found significant difference between the duration of smoking and severity of the disease based on FEV1 values (p= 0.005). A significant moderate inverse correlation existed between pack years of smoking and FEV1 scores. (r= - 0.379, P < 0.001).

Abstract 17304: Sudden Cardiac Death After Acute Heart Failure Hospitalization: Insights From ASCEND-HF

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Sean Pokorney ◽  
Sana M Al-Khatib ◽  
Jie-Lena Sun ◽  
Phillip Schulte ◽  
Christopher M O'Connor ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Acute Heart Failure ◽  
Cardiac Death ◽  
Cox Model ◽  
Composite Endpoint ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Event Rates

Introduction: Despite concerns about sudden cardiac death (SCD) early after acute heart failure (AHF) hospitalization, the incidence of SCD and the factors and associated with its occurrence have not been well defined. We evaluated the incidence and predictors of SCD early after AHF hospitalization. Hypothesis: AHF is associated with SCD. Methods: ASCEND-HF included patients with AHF with any ejection fraction (EF). Clinical events including SCD, resuscitated SCD (RSCD), and sustained ventricular tachycardia/ventricular fibrillation (VT/VF) were adjudicated through 30 days. Patients could have more than one event. These three events were combined to form a new composite endpoint, and baseline characteristics associated with this composite were determined by logistic regression and stepwise selection. RSCD and VT/VF were used as time dependent variables in a Cox model to evaluate the association with 180-day all-cause mortality. Results: Among 7,011 patients with available date on SCD, RSCD, or VT/VF, median age was 67 years (IQR 56-76), median EF was 30% (IQR 20-37%), 9% had a history of VT, and 16% had an ICD. The 30-day event rates were 1.8% (n=121) for the composite, 0.6% for SCD (n=43), 0.4% for RSCD (n=24), and 0.9% for VT/VF (n=64). In the multivariable model, chronic obstructive pulmonary disease, history of VT, male sex, higher admission heart rate, and longer baseline QRS duration were associated with SCD, RSCD, or VT/VF (Table). The composite was independently associated with higher 180-day mortality (adjusted HR 6.6, 95% CI 4.8-9.1, p<0.0001). Conclusions: Patients admitted for AHF had relatively high rates of SCD, RSCD, or VT/VF within 30 days of follow-up, and RSCD or VT/VF were associated with higher 180-day mortality. Further studies are needed to evaluate ways to predict and therapies to prevent and treat tachyarrhythmias early after AHF hospitalization, including in those patients who may be eligible for an ICD after medical therapy has been optimized.

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