scholarly journals Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap

2018 ◽  
Vol 7 (12) ◽  
pp. 517
Author(s):  
Vincent Su ◽  
Diahn-Warng Perng ◽  
Ting-Chun Chou ◽  
Yueh-Ching Chou ◽  
Yuh-Lih Chang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Lower Risk ◽  
Chronic Obstructive ◽  
Research Database ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Acute Exacerbations ◽  
Practice Methods ◽  
Mucolytic Agents

Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to 2009 were enrolled as the BCO and COPD alone cohorts, respectively. Patients followed for <28 days, diagnosed with COPD who were not prescribed with COPD medications, and those diagnosed with bronchiectasis who did not receive a chest X-ray or computed tomography were excluded. The primary endpoints were acute exacerbations and mortality. Results: There were 831 patients in the BCO cohort and 3321 patients in the COPD alone cohort, covering 3763.08 and 17,348.95 person-years, respectively, from 2000 to 2011. The BCO cohort had higher risk for exacerbations (adjusted hazard ratio (HR) 2.26, 95% confidence interval (CI) 1.94–2.63) and mortality (HR 1.46, 95% CI 1.24–1.73) than the COPD alone cohort. In the patients overall, the use of statins, macrolides, and mucolytic agents was associated with significantly lower risks of acute exacerbations (statins, HR 0.37, 95% CI 0.29–0.46; macrolides, HR 0.65, 95% CI 0.45–0.93; mucolytic agents, HR 0.68, 95% CI 0.59–0.78). Statins were associated with a significantly lower risk of mortality (HR 0.32, 95% CI 0.25–0.41). In the BCO group, statins and mucolytic agents use was associated with significantly lower risks of acute exacerbations (statins, HR 0.44, 95% CI 0.29–0.65; mucolytic agents, HR 0.58, 95% CI 0.45–0.75). Conclusion: Statins and mucolytic agents use may lower risk of acute exacerbation in patients with BCO.

scholarly journals Fibrinogen is a promising biomarker for chronic obstructive pulmonary disease: evidence from a meta-analysis

2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Bo Zhou ◽  
Shufang Liu ◽  
Danni He ◽  
Kundi Wang ◽  
Yunfeng Wang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Data Extraction ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Acute Exacerbations ◽  
Global Initiative

Abstract Backgrounds: Some studies have reported association of circulating fibrinogen with the risk of chronic obstructive pulmonary disease (COPD), and the results are conflicting. To yield more information, we aimed to test the hypothesis that circulating fibrinogen is a promising biomarker for COPD by a meta-analysis. Methods: Data extraction and quality assessment were independently completed by two authors. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (95% CI). Results: Forty-five articles involving 5586/18604 COPD patients/controls were incorporated. Overall analyses revealed significantly higher concentrations of circulating fibrinogen in COPD patients than in controls (WMD: 84.67 mg/dl; 95% CI: 64.24–105.10). Subgroup analyses by COPD course showed that the degree of increased circulating fibrinogen in patients with acute exacerbations of COPD (AECOPD) relative to controls (WMD: 182.59 mg/dl; 95% CI: 115.93–249.25) tripled when compared in patients with stable COPD (WMD: 56.12 mg/dl; 95% CI: 34.56–77.67). By COPD severity, there was a graded increase in fibrinogen with the increased severity of COPD relative to controls (Global Initiative for Obstructive Lung Disease (GOLD) I, II, III, and IV: WMD: 13.91, 29.19, 56.81, and 197.42 mg/dl; 95% CI: 7.70–20.11, 17.43–40.94, 39.20–74.41, and −7.88 to 402.73, respectively). There was a low probability of publication bias. Conclusion: Our findings indicate a graded, concentration-dependent, significant relation between higher circulating fibrinogen and more severity of COPD.

scholarly journals P and associated factors of dysglycemia among patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 18 ◽  
pp. 147997312110563
Author(s):  
Khairil K Zulkifli ◽  
Fatimah Z Mohamed Shah ◽  
Ahmad I Ismail ◽  
Thuhairah H Abdul Rahman ◽  
Rohana A Ghani
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Associated Factors ◽  
Hospital Admissions ◽  
Chronic Obstructive ◽  
Newly Diagnosed ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Acute Exacerbations ◽  
History Of

Objectives Dysglycemia is known to be a common comorbidity of chronic obstructive pulmonary disease (COPD). However, undiagnosed dysglycemia and the associated factors remain under-reported. This study aimed to determine the prevalence and the associated factors of dysglycemia among COPD patients. Methods This was a cross-sectional, single-center study involving adults with established COPD ( n = 186) divided into those with or without hospital admissions for acute exacerbation. Oral glucose tolerance test (OGTT) was performed in patients with no known history of dysglycemia. Results There were 16 patients who had overt diabetes, and 32 had prediabetes following the OGTT. Forty percent had histories of hospital admissions for COPD exacerbations. Both groups demonstrated similar 2-h post prandial glucose, glycated hemoglobin (HbA1c) and fasting blood glucose. The incidences of newly diagnosed dysglycemia were higher in both groups (40.8% vs 34.6%, p = 0.57). Cumulative days of admission (≥6 days/year) and weight (≥65 kg) were identified as predictors for dysglycemia within the study population. Discussion This study demonstrated a high number of overt and newly diagnosed dysglycemia among COPD patients who had no previous history of abnormal glucose. Recent acute exacerbations of COPD could have a negative impact on glycemia, although the results did not attain statistical significance. However, there is a need for adequate screening for dysglycemia, particularly among those with frequent acute exacerbations of their condition.

scholarly journals The Association between Glucose Levels and Hospital Outcomes in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 32 (1) ◽  
pp. 62-66
Author(s):  
Saleh Ahmed ◽  
Pritam Bordhan ◽  
Hasan Imam ◽  
Umme Salma
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Nursing Home ◽  
Mean Arterial Pressure ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Glucose Levels ◽  
The Third ◽  
Copd Patients ◽  
Acute Exacerbations

Introduction: Chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death in the world and will become the third most common in a few years. Identification of prognostic factors may lead to improved treatment strategies and clinical outcomes for COPD. To find out the association between glucose levels and hospital outcomes in patients with acute exacerbations of chronic obstructive pulmonary disease. Materials and Methods: This retrospective study was carried out different privet and public hospital in Chandpur. The information reported in this manuscript was collected during three separate projects in the same hospital. The first cohort included 35 COPD patients admitted for an acute exacerbation to a non-ICU bed to determine if there was a relationship between corticosteroid dosage and hyperglycemia. The second cohort included 210 COPD patients with acute exacerbations who were admitted to the MICU to determine factors associated with mortality and LOS. The third cohort included 105 COPD patients who were monitored for re-admission within 30 days after discharge for an acute exacerbation. Results: Mean arterial pressure, hemoglobin, blood urea nitrogen, albumin, nursing home, pleural effusion and intubation were statistically significant (p<0.05) between two group. Intubation had 5.318 (95% CI 2.578 to 11.721) times increase in odds having length of stay. Intubation was significantly associated with length of stay. Conclusion: Mean arterial pressure, hemoglobin, blood urea nitrogen, albumin, nursing home, pleural effusion and intubation were statistically significant between in hospital deaths group and survivors group. Medicine Today 2020 Vol.32(1): 62-66

scholarly journals Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan

2020 ◽  
Vol 17 (14) ◽  
pp. 4980 ◽  
Author(s):  
Li-Ting Kao ◽  
Kuo-Chen Cheng ◽  
Chin-Ming Chen ◽  
Shian-Chin Ko ◽  
Ping-Jen Chen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Healthcare Utilization ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Physical Restraints ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Chronic obstructive pulmonary disease (COPD) is a chronic disease that burdens patients worldwide. This study aims to discover the burdens of health services among COPD patients who received palliative care (PC). Study subjects were identified as COPD patients with ICU and PC records between 2009 and 2013 in Taiwan’s National Health Insurance Research Database. The burdens of healthcare utilization were analyzed using logistic regression to estimate the difference between those with and without cancer. Of all 1215 COPD patients receiving PC, patients without cancer were older and had more comorbidities, higher rates of ICU admissions, and longer ICU stays than those with cancer. COPD patients with cancer received significantly more blood transfusions (Odds Ratio, OR: 1.66; 95% C.I.: 1.11–2.49) and computed tomography scans (OR: 1.88; 95% C.I.: 1.10–3.22) compared with those without cancer. Bronchoscopic interventions (OR: 0.26; 95% C.I.: 0.07–0.97) and inpatient physical restraints (OR: 0.24; 95% C.I.: 0.08–0.72) were significantly more utilized in patients without cancer. COPD patients without cancer appeared to receive more invasive healthcare interventions than those without cancer. The unmet needs and preferences of patients in the life-limiting stage should be taken into consideration for the quality of care in the ICU environment.

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