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D-二聚体/纤维蛋白原比值与复发性加重可能对预测 COPD 加重患者 90 天死亡率有潜在影响。

D-dimer/Fibrinogen ratio and recurrent exacerbations might have a potential impact to predict 90-day mortality in patients with COPD exacerbation.

机构信息

University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.

出版信息

Malawi Med J. 2021 Dec;33(4):276-280. doi: 10.4314/mmj.v33i4.8.

Abstract

BACKGROUND

According to the World Health Organisation reports (WHO), COPD is the third leading cause of overall in the World by 2020.

AIM

We aimed to determine the prognostic predictors of 90-day mortality after an initial exacerbation in patients with acute exacerbation of COPD (AECOPD).

RESULTS

Increased Charlson Comorbidity Score(CCS) (HR:1.47; p<0.05), readmission after initial exacerbation (HR:1.47; p<0.05) were predictive risk factors for 30-day mortality in multivariable regression model. The 90-day mortality rate was %11.8. Hypertension, increased median age, nutrition risk score (NRS), CCS, CAT score, and mMRC 4th level were possible risk factors for 90-day mortality. There was a significant difference in the mortality of patients with D-dimer/Fibrinogen ratios>0.11 and ≤0.11 (HR:2.47; p<0.05). Recurrent exacerbations after discharge were predictive risk factors for 90-day mortality in the multivariable regression model (HR:2.25; p<0.001) with the increased mortality risk 4.73 times (HR:4.73; p=0.002). Furthermore, a 1-unit increment of acute exacerbation increased the mortality risk 3.39 times (HR:3.39; p<0.001).

CONCLUSION

Our study showed that D-dimer/Fibrinogen ratio but not D-dimer and recurrent exacerbations after discharge might have a critical impact on 90-day mortality.

摘要

背景

根据世界卫生组织(WHO)的报告,到 2020 年,COPD 将成为全球第三大致死原因。

目的

我们旨在确定慢性阻塞性肺疾病急性加重(AECOPD)患者初次加重后 90 天死亡率的预后预测因素。

结果

Charlson 合并症评分(CCS)升高(HR:1.47;p<0.05)、初次加重后再入院(HR:1.47;p<0.05)是多变量回归模型中 30 天死亡率的预测危险因素。90 天死亡率为 11.8%。高血压、年龄中位数升高、营养风险评分(NRS)、CCS、CAT 评分和 mMRC 第 4 级是 90 天死亡率的可能危险因素。D-二聚体/纤维蛋白原比值>0.11 和≤0.11 的患者死亡率存在显著差异(HR:2.47;p<0.05)。出院后再次加重是多变量回归模型中 90 天死亡率的预测危险因素(HR:2.25;p<0.001),死亡率风险增加 4.73 倍(HR:4.73;p=0.002)。此外,急性加重程度增加 1 个单位会使死亡率风险增加 3.39 倍(HR:3.39;p<0.001)。

结论

我们的研究表明,D-二聚体/纤维蛋白原比值而非 D-二聚体和出院后再次加重可能对 90 天死亡率有重要影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/452c/8893003/e36a454ffe1f/MMJ3304-0276Fig1.jpg

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