Abstract:
BACKGROUND:Acute exacerbations are the leading causes of hospitalization and mortality in patients with COPD. Prognostic tools for patients with chronic COPD exist, but there are scarce data regarding acute exacerbations. We aimed to identify the prognostic factors of death and readmission after exacerbation of COPD. METHODS:This was a retrospective study conducted in the Department of Internal Medicine of Geneva University Hospitals. All patients admitted to the hospital with a diagnosis of exacerbation of COPD between 2008 and 2011 were included. The studied variables included comorbidities, Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity classification, and biological and clinical parameters. The main outcome was death or readmission during a 5-year follow-up. The secondary outcome was death. Survival analysis was performed (log-rank and Cox). RESULTS:We identified a total of 359 patients (195 men and 164 women, average age 72 years). During 5-year follow-up, 242 patients died or were hospitalized for the exacerbation of COPD. In multivariate analysis, age (hazard ratio [HR] 1.03, 95% CI 1.02-1.05; P<0.0001), severity of airflow obstruction (forced expiratory volume in 1 s <30%; HR 4.65, 95% CI 1.42-15.1; P=0.01), diabetes (HR 1.47, 95% CI 1.003-2.16; P=0.048), cancer (HR 2.79, 95% CI 1.68-4.64; P<0.0001), creatinine (HR 1.003, 95% CI 1.0004-1.006; P=0.02), and respiratory rate (HR 1.03, 95% CI 1.003-1.05; P=0.028) on admission were significantly associated with the primary outcome. Age, cancer, and procalcitonin were significantly associated with the secondary outcome. CONCLUSION:COPD remains of ominous prognosis, especially after exacerbation requiring hospitalization. Baseline pulmonary function remains the strongest predictor of mortality and new admission. Demographic factors, such as age and comorbidities and notably diabetes and cancer, are closely associated with the outcome of the patient. Respiratory rate at admission appears to be the most prognostic clinical parameter. A prospective validation is, however, still required to enable the identification of patients at higher risk of death or readmission.
journal_name
Int J Chron Obstruct Pulmon Disauthors
Flattet Y,Garin N,Serratrice J,Perrier A,Stirnemann J,Carballo Sdoi
10.2147/COPD.S122382subject
Has Abstractpub_date
2017-01-31 00:00:00pages
467-475eissn
1176-9106issn
1178-2005pii
copd-12-467journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Dry powder inhalers (DPIs) are inspiratory flow driven and hence flow dependent. Most patients with chronic obstructive pulmonary disease (COPD) are elderly and have poor lung function. The factors affecting their inspiratory flows through inhalers are unclear. OBJECTIVE:To study peak inspiratory flows (PIF...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/copd.s11474
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journal_title:International journal of chronic obstructive pulmonary disease
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doi:10.2147/COPD.S87714
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究
doi:10.2147/COPD.S77144
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abstract:Purpose:Whole-body vibrating training (WBVT) is a modality aiming to improve neuromuscular performance of patients with COPD. However, a consensus on the effects of WBVT has not been reached. We aimed to clarify the effects of WBVT on functional exercise capacity, pulmonary function, and quality of life in COPD patient...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,meta分析
doi:10.2147/COPD.S176229
更新日期:2018-10-10 00:00:00
abstract:INTRODUCTION:Effects of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) patients with severely impaired health status are poorly documented since these patients are usually excluded from clinical trials. This retrospective, observational study aims to study the impact of disease on health ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S24579
更新日期:2011-01-01 00:00:00
abstract:Background:COPD is characterized by a persistent inflammatory response, especially against cigarette smoke. COPD patients may develop varying degrees of emphysematous destruction of the lungs. A pathophysiological role for miRNAs in COPD has been suggested in several studies. We examined changes in microRNAs expression...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S271864
更新日期:2020-10-29 00:00:00
abstract::Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating as...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S54927
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abstract:Background:Frailty can inform management approaches for individuals with COPD. However, inpatient measures of frailty are seldom employed because they are time-consuming or inapplicable for bed-bound patients. We investigated the feasibility and potential of an innovative sensor-based upper-extremity function (UEF) tes...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S182802
更新日期:2018-12-18 00:00:00
abstract:Introduction and aim:Abnormal brain structure and function in COPD has been reported on MRI. However, the deficit in local synchronization of spontaneous activity in patients with stable COPD remains unknown. The main aim of the present study was to explore spontaneous brain activity in patients with COPD compared with...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S190671
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S136256
更新日期:2017-10-06 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,meta分析,评审
doi:10.2147/COPD.S104238
更新日期:2016-09-16 00:00:00
abstract:BACKGROUND:Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD. METHODS:Prospective cohorts were established among 118 patients with COPD from March 2013 to J...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S84337
更新日期:2015-07-15 00:00:00
abstract:Background:Patients with chronic obstructive pulmonary disease (COPD) often have poor health-related quality of life (HRQoL) that is disproportionate to their degree of airflow limitation. This study evaluated the association between St George's Respiratory Questionnaire for COPD (SGRQ-C) score and forced expiratory vo...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究
doi:10.2147/COPD.S145910
更新日期:2017-11-13 00:00:00
abstract:Introduction:Inhaled corticosteroids (ICSs) are recommended for patients with frequent exacerbation of chronic obstructive pulmonary disease (COPD). However, accumulating evidence has indicated the risk of pneumonia from the use of ICS. This study aimed to investigate the association between ICS and pneumonia in the re...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S286149
更新日期:2020-12-29 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S163795
更新日期:2018-07-30 00:00:00
abstract:PURPOSE:COPD is characterized by an accelerated and progressive decline in forced expiratory volume in 1 second (FEV1) and lung hyperinflation. Although lung hyperinflation is the hallmark of COPD, data on the longitudinal changes in lung hyperinflation and any association with the decline in FEV1 are lacking. The aim ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S122909
更新日期:2017-02-03 00:00:00
abstract:Purpose:Primary care COPD guidelines indicate that COPD patients with asthma characteristics should be treated as having asthma. This study aims to describe the prevalence of asthma characteristics in patients with a pulmonologist-confirmed working diagnosis of COPD or ACO. Patients and Methods:This retrospective cros...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S247819
更新日期:2020-07-06 00:00:00
abstract:BACKGROUND:To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD) with the combination of long-acting β(2)-agonist (LABA), long-acting muscarinic an...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S25805
更新日期:2012-01-01 00:00:00
abstract:Objective:Our aim was to assess the impact of comorbidities on existing COPD prognosis scores. Patients and methods:A total of 543 patients with COPD (FEV1 <80% and FEV1/FVC <70%) were included between January 2003 and January 2004. Patients were stable for at least 6 weeks before inclusion and were followed for 5 yea...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S184695
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S152085
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abstract::Clinical trials of a combination therapy of an inhaled corticosteroid, fluticasone propionate (FP), with a long-acting beta2-agonist, salmeterol (Sal), have demonstrated a greater improvement in lung function and in quality of life measures after the combination compared with either component of alone. In a subanalysi...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/copd.2006.1.3.235
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S147796
更新日期:2017-12-27 00:00:00
abstract:BACKGROUND:Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion. METH...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S77085
更新日期:2015-06-26 00:00:00
abstract:PURPOSE:This study was conducted to determine COPD severity at the time of diagnosis as confirmed by spirometry in patients treated in a US managed care setting. PATIENTS AND METHODS:All patients with one or more inpatient stays, one or more emergency department visits, or two or more outpatient visits with diagnosis ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S16975
更新日期:2011-01-01 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S111254
更新日期:2016-11-03 00:00:00
abstract:Background:Despite chronic obstructive pulmonary disease (COPD) being the commonest non-communicable disease in Nepal, there is limited research evidence estimating the spirometry-based burden of COPD. This study aims to estimate the prevalence of COPD and its correlates through a community-based survey in Pokhara Metr...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S268110
更新日期:2020-09-29 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S80439
更新日期:2015-05-04 00:00:00
abstract::COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is re...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S145573
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abstract::Measurement of inspiratory capacity (IC) as a marker of dynamic lung hyperinflation has been shown to correlate with dyspnea and exercise performance in stable COPD, and is therefore of potential utility in the management of this condition. We have examined whether similar relationships exist during acute exacerbation...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::The landmark study of Fletcher and Peto on the natural history of tobacco smoke-related chronic airflow obstruction suggested that decline in the forced expiratory volume in the first second (FEV(1)) in chronic obstructive pulmonary disease (COPD) is slow at the beginning, becoming faster with more advanced disease. T...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S27480
更新日期:2012-01-01 00:00:00