Prediction of mortality in patients with acute exacerbation of chronic obstructive pulmonary disease
10.3760/cma.j.cn431274-20211124-01222
- VernacularTitle:慢性阻塞性肺疾病急性加重期患者死亡风险预测
- Author:
Hongli XIAO
1
;
Jie YANG
;
Shuai XIA
;
Yufan DU
;
Guoxing WANG
Author Information
1. 首都医科大学附属北京友谊医院急诊科，北京 100050
- Keywords:
Pulmonary disease, chronic obstructive;
Acute exacerbation;
Death;
Risk factors
- From:
Journal of Chinese Physician
2022;24(8):1165-1169,1174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the risk factors of mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A total of 97 patients with AECOPD in the emergency department of Beijing Friendship Hospital Affiliated to Capital Medical University from January 2018 to January 2019 were prospectively selected and followed up for 2.5 years. According to the prognosis, they were divided into survival group (82 cases) and death group (15 cases). Logistic regression analysis was used to screen the independent risk factors for death. The area under receiver operating characteristic curve (AUC) was used to analyze the prediction accuracy. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to analyze the predictive value of the prediction model for 2.5-year mortality in AECOPD patients.Results:Drinking history ( OR=4.975, P=0.046), past long-term β receptor blockers ( OR=5.486, P=0.029) and creatine kinase isoenzyme (CK-MB) level ( OR=2.008, P=0.049) were independent risk factors for death in patients with AECOPD. The AUC was 0.729, 0.715 and 0.710 respectively. The weight values of the three in the prediction model were 5, 5 and 1 respectively and the AUC was 0.834. Kaplan Meier survival analysis showed that 8 points of the prediction model could predict the 2.5-year survival rate in AECOPD patients (Log Rank P<0.001). The risk of death in AECOPD patients with score >8 was significantly higher than that of patients with score ≤8 ( HR=12.471, 95% CI: 3.735-41.643, P<0.001). Conclusions:Drinking history, past long-term β receptor blockers and CK-MB levels are independent risk factors for 2.5-year mortality in patients with AECOPD. The combination of these three factors has high predictive value for the prognosis of patients.
