University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Malawi Med J. 2021 Dec;33(4):276-280. doi: 10.4314/mmj.v33i4.8.
According to the World Health Organisation reports (WHO), COPD is the third leading cause of overall in the World by 2020.
We aimed to determine the prognostic predictors of 90-day mortality after an initial exacerbation in patients with acute exacerbation of COPD (AECOPD).
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).
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.
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。
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。
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）。
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。
