scholarly journals Comparison of diagnostic values of haematological and inflammatory parameters in predicting COPD exacerbation

Pneumologia ◽  
2021 ◽  
Vol 69 (4) ◽  
pp. 227-233
Author(s):  
Aseih Hatefi Olaee ◽  
Fariba Rezaeetalab ◽  
Nasim Lotfinejad
Keyword(s):  
Acute Exacerbation ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Cross Sectional Study ◽  
Albumin Level ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Inflammatory Parameters

Abstract Objective: Many patients with chronic obstructive pulmonary disease (COPD) suffer from acute exacerbation. Acute exacerbation of COPD (AECOPD) is currently known as the most important leading cause of death worldwide. Therefore, recognising beneficial biomarkers in order to detect acute exacerbations promptly is crucial. This study aimed to evaluate the role of haematological and inflammatory parameters in the diagnosis of AECOPD. Methods: This cross-sectional study was carried out on 63 patients with AECOPD, during exacerbation and stable period, and on 62 sex- and age-matched healthy controls. Haematological and inflammatory parameters were analysed, and other data were collected. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP) level, and mean platelet volume (MPV) in the diagnosis of patients with AECOPD. Results: The predictive ability of NLR was higher than that of CRP and MPV. The cut-off value of NLR was 2.85, and the sensitivity and specificity for detecting AECOPD were 87% and 70%, respectively (AUC = 0.84, P < 0.001). NLR values positively correlated with the CRP level, erythrocyte sedimentation rate (ESR) and platelet (PLT) count (r = 0.44, P = 0.001; r = 0.31, P = 0.020; and r = 0.32, P = 0.010, respectively) and negatively correlated with the albumin level and MPV in patients with AECOPD (r = −0.31, P = 0.049 and r = −0.27, P = 0.040). Conclusion: NLRs and CRP levels were both increased in patients with AECOPD, and they are both available and beneficial markers in the prompt detection of AECOPD. Further studies should be performed to underpin the diagnostic and prognostic values of haematological and inflammatory biomarkers in patients with COPD.

scholarly journals Correlation between Arterial and Venous Blood Electrolytes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Cross-sectional Study

2021 ◽  
Author(s):  
Bhavesh Ramji Sadariya ◽  
Amitkumar Virji Maheshwari ◽  
Hardik N Javia ◽  
Hariom Sharma
Keyword(s):  
Acute Exacerbation ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
P Value ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Blood Electrolytes ◽  
Arterial Blood ◽  
Ionised Calcium

Introduction: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is a common health problem coupled with huge mortality and morbidity across the world. Acute exacerbation in COPD patients leads to electrolyte disturbances. Routinely, electrolytes are measured from venous blood. Electrolytes can also be measured from whole blood by blood gas analyser along with blood gases measurement. Aim: To study the correlation between venous and arterial blood electrolytes in AECOPD patients. Materials and Methods: The cross-sectional study was conducted at Clinical Biochemistry Laboratory, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India, from December 2013 to May 2014. Arterial and venous blood were taken at same time from 150 patients of AECOPD and analysed for electrolytes (sodium, potassium and ionised calcium) in arterial blood gas analyser. Correlation of arterial and venous blood electrolyte levels was done by Pearson’s correlation. Results: This study comprised 109 (72.67%) male and 41 (27.33%) female AECOPD patients. Mean age of subjects was 59.01±11.42 years. Mean level of arterial sodium was 143.1±8.81 mmol/L and venous sodium was 144.8±8.47 mmol/L (p-value=0.0973). Mean level of arterial potassium was 3.53±0.73 mmol/L and venous potassium was 3.19±0.56 mmol/L (p-value <0.0001). Mean level of arterial ionised calcium was 0.83±0.13 mmol/L and venous ionised calcium was 0.76±0.17 mmol/L (p-value <0.0001). Correlation coefficient values for sodium, potassium and ionised calcium were 0.878, 0.762 and 0.537, respectively. Conclusion: Arterial sodium and potassium can be used as a substitute of venous sodium and potassium in management of AECOPD patients, while arterial ionised calcium should not be used in place of venous ionised calcium in management of such patients.

scholarly journals Immunophenotype in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

2021 ◽  
Author(s):  
Xiao-feng Xiong ◽  
Min Zhu ◽  
Hong-xia Wu ◽  
Li-li Fan ◽  
De-yun Cheng
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Exacerbation ◽  
Th17 Cells ◽  
Cross Sectional Study ◽  
Th2 Cells ◽  
Chronic Obstructive ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Cell Ratio

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and the immune inflammatory response is thought to play an important role in pathogenesis. However, the immunophenotype of patients with COPD is unknown. Herein, we evaluated the immunophenotype of patients with acute exacerbation of COPD (AECOPD).Methods: A cross-sectional study was conducted in West China Hospital from September 2018 to October 2019. The proportion of CD4+ T lymphocyte subtypes (Th1, Th2, Th17 and Treg) and the levels of serum cytokines in the peripheral blood of patients with AECOPD, stable COPD (SCOPD), and healthy controls (HCs) were evaluated.Results: A total of 34 HCs, 53 patients with SCOPD, and 75 patients with AECOPD were included. Compared with patients with SCOPD, Th1 cells, Th17 cells, Treg cell ratio, Th1/Th2 cell ratio, and the levels of C-reactive protein, interleukin (IL)-6, and IL-10 were significantly increased in patients with AECOPD (P < 0.001), while the proportion of Th2 cells was significantly reduced (P < 0.01). The proportion of Th17 cells was positively correlated with COPD Assessment Test score (r = 0.243, P = 0.006), modified Medical Research Council dyspnea score (r = 0.326, P < 0.0001), and Th1 cell ratio (r = 0.353, P < 0.0001), and negatively correlated with the forced vital capacity (r = -0.308，P = 0.014) and proportion of Th2 cells (r = -0.653, P < 0.0001).Conclusions: The immunophenotype of patients with AECOPD shows abnormal activation of Th1, Th17 and Treg cells. There is a correlation between the proportion of Th17 cells and the severity of COPD; therefore, this may represent a novel index for the evaluation of COPD severity.Trial registration: China Clinical Trials Registry, ChiCTR1800018452, registered 19 September 2018, https://www.chictr.org.cn/index.aspx.

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

scholarly journals Breathlessness and opioid prescribing in COPD in general practice: a cross-sectional, observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 00299-2019
Author(s):  
David C. Currow ◽  
Miriam J. Johnson ◽  
Allan Pollack ◽  
Diana H. Ferreira ◽  
Slavica Kochovska ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Pain Patient ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Obstructive Pulmonary Disease ◽  
Health Database

Chronic breathlessness is a disabling syndrome, prevalent in people with advanced chronic obstructive pulmonary disease (COPD). Regular, low-dose, oral sustained-release morphine is approved in Australia to reduce symptomatic chronic breathlessness. We aimed to determine the current prescribing patterns of opioids for chronic breathlessness in COPD in Australian general practice and to define any associated patient and practitioner characteristics.Five years (2011 to 2016) of the Bettering the Evaluation and Care of Health database, an Australian national, continual, cross-sectional study of clinical care in general practice were used. The database included 100 consecutive clinical encounters from almost 1000 general practitioners annually (n=488 100 encounters). Descriptive analyses with subsequent regression models were generated.Breathlessness as a patient-defined reason for encounter was identified in 621 of 4522 encounters where COPD was managed. Opioids were prescribed in 309 of 4522 encounters where COPD was managed (6.8%; (95% CI) 6.1–7.6), of which only 17 were prescribed for breathlessness, and the rest for other conditions almost entirely related to pain. Patient age (45–64 years versus age 80+ years, OR 1.68; 1.19–2.36), Commonwealth Concession Card holders (OR 1.70; 1.23–2.34) and socioeconomic disadvantage (OR 1.30; 1.01–1.68) were associated with increased likelihood of opioid prescription at COPD encounters. The rate of opioid prescriptions rose over the 5 years of study.In primary care encounters for COPD, opioids were prescribed in 6.8% of cases, but almost never for breathlessness. These data create a baseline against which to compare changes in prescribing as the treatment of chronic breathlessness evolves.

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