scholarly journals Validation of the modified nutric score on critically ill patients with acute exacerbations of chronic obstructive pulmonary disease: A retrospective study

2021 ◽  
Vol 8 (9) ◽  
pp. 546-550
Author(s):  
Guler Doganay ◽  
Mustafa Ozgur Cirik ◽  
Gulsah Yurtseven ◽  
Ali Alagoz
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Critically Ill ◽  
Apache Ii ◽  
Nutritional Risk ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Copd Patients

Objective: In critical care patients, the nutritional status is related to many factors such as existing co-morbidities, nutritional history, and the current disease. It is crucial to apply a comprehensive nutritional assessment and to start nutritional support as soon as possible in intensive care unit(ICU) where malnutrition is common. There are many studies on the association between modified Nutritional Risk in Critical Patients (mNUTRIC) score and outcome in ICU patients but the effectiveness of tools for risk assessment is still remains unclear. We aimed to define the correlation between the mNUTRIC score and 28-day mortality in patients with chronic obstructive pulmonary disease (COPD) in ICU. Materials and Methods: The admission of COPD patients to the respiratory ICU in 2018 were determined retrospectively. Demographic data of all patients, body mass index (BMI), mNUTRIC scores, Acute Physiology and Chronic Health Assessment II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores, Charlson Comorbidity Index (CCI), time from patient ward to ICU admission, sepsis parameters including C-reactive protein (CRP) and procalcitonin,  ICU length of stay (LOS ICU), vasopressor use, and 28-day mortality were recorded. Results: 159 COPD patients were involved in the study. Age, CCI, day from patient ward to ICU admission, SOFA score, APACHE II score and 28-day mortality were detected to be statistically higher in patients with mNUTRIC ≥ 5 (p < 0.05). Conclusion: The mNUTRIC score could be an proper method for nutritional risk to predict prognosis in critically ill COPD patients.

scholarly journals Validation of the modified NUTRIC Score on Critically Ill Patients with Acute Excacerbations of Chronic Obstructive Pulmonary Disease: A retrospective study

2021 ◽  
Author(s):  
Guler Eraslan Doganay ◽  
Mustafa Ozgur Cirik ◽  
Ali Alagoz ◽  
Gulsah Yurtseven
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Critically Ill ◽  
Apache Ii ◽  
Nutritional Risk ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Copd Patients

Background In critical care patients, the nutritional status is related to many factors such as existing co-morbidities, nutritional history, and the current disease. It is crucial to apply a comprehensive nutritional assesment and to start nutritional support as soon as possible in intensive care unit(ICU) where malnutrition is common. There are many studies on association between modified Nutritional Risk in Critical Patients (mNUTRIC) score and outcome in ICU patients but the effectiveness of tools for risk assesment isn’t still remains unclear. We aimed to define the correlation between the mNUTRIC score and 28-day mortality in patients with chronic obstructive pulmonary disease (COPD) in ICU. Materials and Methods The admission of COPD patients to the respiratory ICU in 2018 were determined retrospectively. Demograpic data of all patients, body mass index (BMI), mNUTRIC scores, Acute Physiology and Chronic Health Assessment II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores, Charlson Comorbidity Index (CCI), time from patient ward to ICU admission, sepsis parameters including C-reactive protein (CRP) and procalcitonin, ICU length of stay (LOS ICU), vasopressor use, and 28-day mortality were recorded. Results 159 COPD patients involved the study. Age, CCI, day from patient ward to ICU admission, SOFA score, APACHE II score and 28-day mortality were detected to be statistically higher in patients with mNUTRIC ≥ 5 (p < 0.05). Conclusion The mNUTRIC score could be an proper method for nutritional risk to predict prognosis in critically ill COPD patients.

scholarly journals Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

2018 ◽  
Vol 119 (5) ◽  
pp. 543-551 ◽  
Author(s):  
Arora R. Ingadottir ◽  
Anne M. Beck ◽  
Christine Baldwin ◽  
C. Elizabeth Weekes ◽  
Olof G. Geirsdottir ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Protein Intake ◽  
Nutritional Risk ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Oral Nutritional Supplements

AbstractLow energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015–March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1–5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

scholarly journals Invasive Pulmonary Aspergillosis in Chronic Obstructive Pulmonary Disease Exacerbations

2020 ◽  
Vol 41 (06) ◽  
pp. 851-861
Author(s):  
Pierre Bulpa ◽  
Fabrice Duplaquet ◽  
George Dimopoulos ◽  
Dirk Vogelaers ◽  
Stijn Blot
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Critically Ill ◽  
Invasive Pulmonary Aspergillosis ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Tissue Samples ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Chronic Corticosteroid

AbstractNowadays, reports in the literature support that patients with severe chronic obstructive pulmonary disease (COPD) are at higher risk to develop invasive pulmonary aspergillosis (IPA). However, the interpretation of Aspergillus-positive cultures from the airways in critically ill COPD is still a challenge. Indeed, as the patient could be merely colonized, tissue samples are required to ascertain IPA diagnosis but they are rarely obtained before death. Consequently, diagnosis is often only suspected on the basis of a combination of three elements: clinical characteristics, radiological images (mostly thoracic CT scan), and microbiological, and occasionally serological, results. To facilitate the analysis of these data, several algorithms have been developed, and the best effectiveness has been demonstrated by the Clinical algorithm. This is of importance as IPA prognosis in these patients remains presently very poor and using such an algorithm could promote prompter diagnosis, early initiation of treatment, and subsequently improved outcome.While the most classical presentation of IPA in critically ill COPD patients features a combination of obstructive respiratory failure, antibiotic-resistant pneumonia, recent or chronic corticosteroid therapy, and positive Aspergillus cultures from the lower respiratory tract, the present article will also address less typical presentations and discuss the most appropriate treatments which could alter prognosis.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

Clinical and functional peculiarities at patients with bronchial asthma, chronic obstructive pulmonary disease and overlap of asthma-chronic obstructive pulmonary disease

2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bronchial Asthma ◽  
Blood Test ◽  
Chronic Obstructive ◽  
Inflammation Markers ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Functional Features ◽  
Lower Airways

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.

scholarly journals LINC01414/LINC00824 genetic polymorphisms in association with the susceptibility of chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoman Zhou ◽  
Yunjun Zhang ◽  
Yutian Zhang ◽  
Quanni Li ◽  
Mei Lin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Genetic Polymorphisms ◽  
Chronic Obstructive ◽  
Nucleotide Polymorphisms ◽  
Obstructive Pulmonary Disease ◽  
Logistic Analysis ◽  
Copd Patients ◽  
Increased Risk ◽  
And Gender

Abstract Objective Chronic obstructive pulmonary disease (COPD) is a complicated multi-factor, multi-gene disease. Here, we aimed to assess the association of genetic polymorphisms in LINC01414/ LINC00824 and interactions with COPD susceptibility. Methods Three single nucleotide polymorphisms (SNPs) in LINC01414/LINC00824 was genotyped by Agena MassARRAY platform among 315 COPD patients and 314 controls. Logistic analysis adjusted by age and gender were applied to estimate the genetic contribution of selected SNPs to COPD susceptibility. Results LINC01414 rs699467 (OR = 0.73, 95% CI 0.56–0.94, p = 0.015) and LINC00824 rs7815944 (OR = 0.56, 95% CI 0.31–0.99, p = 0.046) might be protective factors for COPD occurrence, while LINC01414 rs298207 (OR = 2.88, 95% CI 1.31–6.31, p = 0.008) risk-allele was related to the increased risk of COPD in the whole population. Rs7815944 was associated with the reduced risk of COPD in the subjects aged > 70 years (OR = 0.29, p = 0.005). Rs6994670 (OR = 0.57, p = 0.007) contribute to a reduced COPD risk, while rs298207 (OR = 7.94, p = 0.009) was related to a higher susceptibility to COPD at age ≤ 70 years. Rs298207 (OR = 2.54, p = 0.043) and rs7815944 (OR = 0.43, p = 0.028) variants was associated COPD risk among males. Rs7815944 (OR = 0.16, p = 0.031) was related to the reduced susceptibility of COPD in former smokers. Moreover, the association between rs298207 genotype and COPD patients with dyspnea was found (OR = 0.50, p = 0.016), and rs7815944 was related to COPD patients with wheezing (OR = 0.22, p = 0.008). Conclusion Our finding provided further insights into LINC01414/LINC00824 polymorphisms at risk of COPD occurrence and accumulated evidence for the genetic susceptibility of COPD.

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

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199012
Author(s):  
Yiben Huang ◽  
Jiedong Ma ◽  
Bingqian Jiang ◽  
Naiping Yang ◽  
Fangyi Fu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Pulmonary Disease ◽  
Nutritional Risk ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Nrs 2002

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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