Department of Medicine, Respiratory Medicine Unit and Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Expert Rev Respir Med. 2020 May;14(5):493-500. doi: 10.1080/17476348.2020.1732823. Epub 2020 Feb 21.
: In a subset of chronic obstructive pulmonary disease (COPD)patients the course of the disease is complicated by a severe acute exacerbations (AECOPD) that may require hospitalization, at which time negative outcomes may occur up to 30 days after discharge. Several predictors of negative outcomes have been documented.: We considered five negative outcomes related to patients hospitalized with AECOPD: treatment failure, noninvasive mechanical ventilation (NIMV) failure, prolonged length of hospital stay (LHS), short-term mortality (≤ 90 days from admission and including the in-hospital mortality), and early readmission (≤30 days from discharge). Possible therapeutic and preventive strategies to improve these outcomes are outlined and discussed.: Several strategies have been proposed to improve outcomes. Among these, steroid or antibiotic use may reduce the risks of treatment failure or of prolonged hospital stay. We note that operator-related factors may influence the outcome of NIMV. However, little has been documented about the short-term mortality or early readmission rates. In general, few interventions consistently improve negative outcomes and prognosis of AECOPD.
在慢性阻塞性肺疾病（COPD）患者中，疾病的病程会因严重的急性加重（AECOPD）而复杂化，这可能需要住院治疗，此时，在出院后 30 天内可能会出现不良后果。已经记录了一些不良后果的预测因素。我们考虑了与 AECOPD 住院相关的五个不良后果：治疗失败、无创机械通气（NIMV）失败、住院时间延长（LHS）、短期死亡率（入院后≤90 天，包括院内死亡率）和早期再入院（出院后≤30 天）。概述并讨论了可能的治疗和预防策略，以改善这些结果。已经提出了几种改善预后的策略。其中，类固醇或抗生素的使用可能会降低治疗失败或住院时间延长的风险。我们注意到，与操作者相关的因素可能会影响 NIMV 的结果。但是，有关短期死亡率或早期再入院率的记录很少。一般来说，很少有干预措施能持续改善 AECOPD 的不良后果和预后。
