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中国慢性阻塞性肺疾病急性加重住院患者的特征、管理和院内临床结局:ACURE 研究 I 期数据结果。

Characteristics, Management and In-Hospital Clinical Outcomes Among Inpatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in China: Results from the Phase I Data of ACURE Study.

机构信息

Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, People's Republic of China.

Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.

出版信息

Int J Chron Obstruct Pulmon Dis. 2021 Feb 25;16:451-465. doi: 10.2147/COPD.S281957. eCollection 2021.

Abstract

PURPOSE

The study aimed to give a comprehensive overview of characteristics and evaluate in-hospital clinical outcomes among hospitalized acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients in China using data from the AECOPD inpatient registry (ACURE).

PATIENTS AND METHODS

The ACURE is an ongoing, national, multicenter, observational registry. Participants enrolled during phase I stage (1 September 2017 to 25 February 2020) of ACURE with confirmed AECOPD diagnoses were studied. Descriptive analyses were conducted to describe features and occurrences of in-hospital clinical outcomes of AECOPD inpatients in real-world China.

RESULTS

A total of 5334 AECOPD inpatients from 163 sites in 28 provinces or province-level municipalities were included. Among all participants, 78.8% were males and the median age was 69.0 [interquartile range (IQR): 63.0-76.0] years. The proportions of current and former smokers were 23.6% and 44.2%, respectively. The median age at COPD diagnosis was 64.0 (IQR: 57.0-71.0) years and 88.7% participants demonstrated at least one comorbidity. During stable period, only 56.9% subjects received pharmacological therapies and the influenza vaccination rate was 2.9%. During hospitalization, 99.5% subjects received pharmacological treatments and antibiotics were prescribed to 90.9% participants. The all-cause in-hospital mortality was 0.1% and no significant difference was found across hospital categories.

CONCLUSION

Clinical features of Chinese AECOPD inpatients were different from those of other populations. In real-world China, the clinical management during stable period was unsatisfied, whereas therapy during hospitalization was effective regarding in-hospital clinical outcomes regardless of hospital category.

摘要

目的

本研究旨在利用中国慢性阻塞性肺疾病急性加重(AECOPD)住院患者登记(ACURE)的数据,全面概述中国住院 AECOPD 患者的特征并评估其住院临床结局。

方法

ACURE 是一项正在进行的全国多中心观察性登记研究。在 ACURE 的第一阶段(2017 年 9 月 1 日至 2020 年 2 月 25 日)期间招募并确诊为 AECOPD 的患者参与了研究。采用描述性分析方法描述了真实世界中中国 AECOPD 住院患者的特征和住院临床结局的发生情况。

结果

共纳入来自中国 28 个省或省直辖市的 163 个中心的 5334 例 AECOPD 住院患者。所有参与者中,男性占 78.8%,中位年龄为 69.0[四分位数间距(IQR):63.0-76.0]岁。当前吸烟者和既往吸烟者的比例分别为 23.6%和 44.2%。COPD 的中位诊断年龄为 64.0(IQR:57.0-71.0)岁,88.7%的患者至少存在一种合并症。在稳定期,仅有 56.9%的患者接受了药物治疗,流感疫苗接种率为 2.9%。住院期间,99.5%的患者接受了药物治疗,90.9%的患者接受了抗生素治疗。总病死率为 0.1%,不同医院类别之间无显著差异。

结论

中国 AECOPD 住院患者的临床特征与其他人群不同。在真实世界的中国,稳定期的临床管理不尽人意,而无论医院类别如何,住院期间的治疗对住院临床结局都是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60ac/7920502/ce1244e085ee/COPD-16-451-g0001.jpg

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