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Prediction of short term re-exacerbation in patients with acute exacerbation of chronic obstructive pulmonary disease.

Liu D, Peng SH, Zhang J, Bai SH, Liu HX, Qu JM - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: The re-exacerbation rate in 90 days was 48.9% (86 out of 176).The re-exacerbation index showed good discrimination for re-exacerbation, with a C-statistic of 0.750 (P<0.001).Further studies are required to verify these findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.

ABSTRACT

Background: The objective of the study is to develop a scoring system for predicting a 90-day re-exacerbation in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Methods: A total of 176 consecutive hospitalized patients with AECOPD were included. The sociodemographic characteristics, status before acute exacerbation (AE), presentations of and treatment for the current AE, and the re-exacerbation in 90 days after discharge from hospital were collected.

Results: The re-exacerbation rate in 90 days was 48.9% (86 out of 176). It was associated with the degree of lung function impairment (Global initiative for chronic Obstructive Lung Disease [GOLD] grades), frequency of AE in the previous year, and parameters of the current AE, including pleural effusion, use of accessory respiratory muscles, inhaled long-acting β-2-agonists, inhaled corticosteroids, controlled oxygen therapy, noninvasive mechanical ventilation, and length of hospital stay, but was not associated with body mass index, modified Medical Research Council scale, or chronic obstructive pulmonary disease assessment test. A subgroup of ten variables was selected and developed into the re-exacerbation index scoring system (age grades, GOLD grades, AE times in the previous year, pleural effusion, use of accessory respiratory muscles, noninvasive mechanical ventilation, controlled oxygen therapy, inhaled long-acting β-2-agonists and inhaled corticosteroids, and length of hospital stay). The re-exacerbation index showed good discrimination for re-exacerbation, with a C-statistic of 0.750 (P<0.001).

Conclusion: A comprehensive assessment integrating parameters of stable chronic obstructive pulmonary disease, clinical presentations at exacerbation, and treatment showed a strong predictive capacity for short-term outcome in patients with AECOPD. Further studies are required to verify these findings.

No MeSH data available.


Related in: MedlinePlus

The relationship between the rate of re-exacerbation and the re-AE INDEX scores.Notes: Patients were divided into three groups depending upon the tertile of the re-AE INDEX score, and the re-exacerbation rate was compared among groups.Abbreviation: Re-AE INDEX, re-exacerbation index.
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f1-copd-10-1265: The relationship between the rate of re-exacerbation and the re-AE INDEX scores.Notes: Patients were divided into three groups depending upon the tertile of the re-AE INDEX score, and the re-exacerbation rate was compared among groups.Abbreviation: Re-AE INDEX, re-exacerbation index.

Mentions: As mentioned in the statistical analysis section, a three-grade re-AE INDEX (2–6 scores, 7–8 scores, and 9–15 scores) was constructed on the basis of increment of scores. Figure 1 shows the increasing risk of re-exacerbation with the increment of re-AE INDEX scores. In the patients with a score of 9–15, 77% of them had at least one time of re-exacerbation in the following 90 days after discharge. For the patients with a score less than 6, the chance was only 26%. Patients with a higher score of re-AE INDEX had more chances to re-exacerbate compared with those with lower scores.


Prediction of short term re-exacerbation in patients with acute exacerbation of chronic obstructive pulmonary disease.

Liu D, Peng SH, Zhang J, Bai SH, Liu HX, Qu JM - Int J Chron Obstruct Pulmon Dis (2015)

The relationship between the rate of re-exacerbation and the re-AE INDEX scores.Notes: Patients were divided into three groups depending upon the tertile of the re-AE INDEX score, and the re-exacerbation rate was compared among groups.Abbreviation: Re-AE INDEX, re-exacerbation index.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494178&req=5

f1-copd-10-1265: The relationship between the rate of re-exacerbation and the re-AE INDEX scores.Notes: Patients were divided into three groups depending upon the tertile of the re-AE INDEX score, and the re-exacerbation rate was compared among groups.Abbreviation: Re-AE INDEX, re-exacerbation index.
Mentions: As mentioned in the statistical analysis section, a three-grade re-AE INDEX (2–6 scores, 7–8 scores, and 9–15 scores) was constructed on the basis of increment of scores. Figure 1 shows the increasing risk of re-exacerbation with the increment of re-AE INDEX scores. In the patients with a score of 9–15, 77% of them had at least one time of re-exacerbation in the following 90 days after discharge. For the patients with a score less than 6, the chance was only 26%. Patients with a higher score of re-AE INDEX had more chances to re-exacerbate compared with those with lower scores.

Bottom Line: The re-exacerbation rate in 90 days was 48.9% (86 out of 176).The re-exacerbation index showed good discrimination for re-exacerbation, with a C-statistic of 0.750 (P<0.001).Further studies are required to verify these findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.

ABSTRACT

Background: The objective of the study is to develop a scoring system for predicting a 90-day re-exacerbation in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Methods: A total of 176 consecutive hospitalized patients with AECOPD were included. The sociodemographic characteristics, status before acute exacerbation (AE), presentations of and treatment for the current AE, and the re-exacerbation in 90 days after discharge from hospital were collected.

Results: The re-exacerbation rate in 90 days was 48.9% (86 out of 176). It was associated with the degree of lung function impairment (Global initiative for chronic Obstructive Lung Disease [GOLD] grades), frequency of AE in the previous year, and parameters of the current AE, including pleural effusion, use of accessory respiratory muscles, inhaled long-acting β-2-agonists, inhaled corticosteroids, controlled oxygen therapy, noninvasive mechanical ventilation, and length of hospital stay, but was not associated with body mass index, modified Medical Research Council scale, or chronic obstructive pulmonary disease assessment test. A subgroup of ten variables was selected and developed into the re-exacerbation index scoring system (age grades, GOLD grades, AE times in the previous year, pleural effusion, use of accessory respiratory muscles, noninvasive mechanical ventilation, controlled oxygen therapy, inhaled long-acting β-2-agonists and inhaled corticosteroids, and length of hospital stay). The re-exacerbation index showed good discrimination for re-exacerbation, with a C-statistic of 0.750 (P<0.001).

Conclusion: A comprehensive assessment integrating parameters of stable chronic obstructive pulmonary disease, clinical presentations at exacerbation, and treatment showed a strong predictive capacity for short-term outcome in patients with AECOPD. Further studies are required to verify these findings.

No MeSH data available.


Related in: MedlinePlus