Department of Clinical Laboratory, The First People's Hospital of YongKang, Yongkang, Zhejiang, China.
School of Public Heath, 117839Hangzhou Medical College, Hangzhou, Zhejiang, China.
Sci Prog. 2021 Oct;104(4):368504211066003. doi: 10.1177/00368504211066003.
Chronic obstructive pulmonary disease (COPD) increases the global disease burden due to its diverse adverse health effects on the respiratory and cardiovascular systems. This study aimed to elucidate the potential indicators of length of stay (LOS) and pharmacotherapy advice among COPD patients. Thereafter, hospitalized COPD patients with clinical records and respiratory and cardiovascular pharmacotherapy advice were retrospectively collected from a tertiary hospital between April 2017 and September 2020, and the determinants of LOS and cardiovascular pharmacotherapy advice were explored using regression analyses. Overall, 475 patients with COPD were recruited and stratified according to exacerbation and presence of Cor pulmonale (CP). The extended LOS, increased B-type natriuretic peptides (BNP), and a higher percentage of cardiovascular pharmacotherapy advice were observed in COPD with CP regardless of exacerbation, although the percentage of respiratory prescriptions was comparable. The presence of CP indicated a longer LOS ( = 1.850, p < 0.001) for COPD regardless of exacerbation. Meanwhile, elevated BNP levels indicated cardiovascular pharmacotherapy advise for both COPD in exacerbation (OR = 1.003, p = 0.012) and absence of exacerbation (OR = 1.006, p = 0.015). Moreover, advice for trimetazidine use for COPD in exacerbation (OR = 1.005, p = 0.002) has been suggested. Therefore, CP appears to be an important comorbidity resulting in extended LOS for COPD, which is likely to be advised with cardiovascular pharmacotherapy, which might be guided through BNP monitoring.
慢性阻塞性肺疾病（COPD）因其对呼吸系统和心血管系统的多种不良健康影响而增加了全球疾病负担。本研究旨在阐明 COPD 患者住院时间（LOS）和药物治疗建议的潜在指标。此后，从 2017 年 4 月至 2020 年 9 月，在一家三级医院回顾性收集了具有临床记录和呼吸及心血管药物治疗建议的住院 COPD 患者，并使用回归分析探讨了 LOS 和心血管药物治疗建议的决定因素。总体而言，共招募了 475 例 COPD 患者，并根据加重和肺心病（CP）的存在进行分层。无论是否加重，CP 存在的 COPD 患者的 LOS 延长、B 型利钠肽（BNP）升高和心血管药物治疗建议的比例更高，尽管呼吸处方的比例相当。CP 的存在表明无论是否加重，COPD 的 LOS 都会延长（ = 1.850，p < 0.001）。同时，BNP 水平升高表明 COPD 加重（OR = 1.003，p = 0.012）和不加重（OR = 1.006，p = 0.015）都需要心血管药物治疗建议。此外，还建议对 COPD 加重患者使用曲美他嗪（OR = 1.005，p = 0.002）。因此，CP 似乎是一种重要的合并症，导致 COPD 的 LOS 延长，可能需要进行心血管药物治疗建议，这可能通过 BNP 监测来指导。
