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多维指标在慢性阻塞性肺疾病死亡率预测中的作用

The Role of Multidimensional Indices for Mortality Prediction in Chronic Obstructive Pulmonary Disease.

作者信息

Kotlyarov Stanislav

机构信息

Department of Nursing, Ryazan State Medical University, 390026 Ryazan, Russia.

出版信息

Diagnostics (Basel). 2023 Apr 4;13(7):1344. doi: 10.3390/diagnostics13071344.

Abstract

(1) Background: Chronic obstructive pulmonary disease (COPD) is one of the most important respiratory diseases. It is characterised by a progressive course with individual differences in clinical presentation and prognosis. The use of multidimensional indices such as the BODE, eBODE, BODEX, CODEX, ADO, and Charlson Comorbidity Index has been proposed to predict the survival rate of COPD patients. However, there is limited research on the prognostic significance of these indices in predicting long-term survival rates in patients with COPD. The aim of this prospective cohort study was to investigate the prognostic value of the BODE, eBODE, BODEX, CODEX, ADO, COTE and Charlson Comorbidity Index in predicting 5- and 10-year survival in patients with COPD. (2) Methods: A total of 170 patients were included in the study and their clinical and functional characteristics of COPD progression, such as dyspnoea, body mass index and spirometry data, were evaluated. A Kaplan-Meier survival analysis was used to calculate 5- and 10-year survival rates. The predictive value of each index was assessed using Cox proportional hazards regression models. (3) Results: The 5-year survival rate was 62.35% and the 10-year survival rate was 34.70%. The BODE, eBODE, BODEX, CODEX, ADO, COTE and Charlson Comorbidity Index were all significantly associated with the 10-year survival rate of COPD patients ( < 0.05). The hazard ratios (HRs) for these indices were as follows: BODE (HR = 1.30, 95% confidence interval [CI] 1.21-1.39); eBODE (HR = 1.29, 95% CI 1.21-1.37); BODEX (HR = 1.48, 95% CI 1.35-1.63); CODEX (HR = 1.42, 95% CI 1.31-1.54); COTE (HR = 1.55, 95% CI 1.36-1.75); ADO (HR = 1.41, 95% CI 1.29-1.54); and Charlson Comorbidity Index (HR = 1.35, 95% CI 1.22-1.48). (4) Conclusions: The multidimensional indices are a useful clinical tool for assessing the course and prognosis of COPD. These indices can be used to identify patients at a high risk of mortality and guide the management of COPD patients.

摘要

(1)背景:慢性阻塞性肺疾病(COPD)是最重要的呼吸系统疾病之一。其病程呈进行性发展,临床表现和预后存在个体差异。有人提出使用多维指标,如BODE、eBODE、BODEX、CODEX、ADO和Charlson合并症指数来预测COPD患者的生存率。然而,关于这些指标在预测COPD患者长期生存率方面的预后意义的研究有限。这项前瞻性队列研究的目的是探讨BODE、eBODE、BODEX、CODEX、ADO、COTE和Charlson合并症指数在预测COPD患者5年和10年生存率方面的预后价值。(2)方法:本研究共纳入170例患者,评估了他们COPD进展的临床和功能特征,如呼吸困难、体重指数和肺功能测定数据。采用Kaplan-Meier生存分析计算5年和10年生存率。使用Cox比例风险回归模型评估每个指标的预测价值。(3)结果:5年生存率为62.35%,10年生存率为34.70%。BODE、eBODE、BODEX、CODEX、ADO、COTE和Charlson合并症指数均与COPD患者的10年生存率显著相关(P<0.05)。这些指标的风险比(HR)如下:BODE(HR = 1.30,95%置信区间[CI] 1.21 - 1.39);eBODE(HR = 1.29,95%CI 1.21 - 1.37);BODEX(HR = 1.48,95%CI 1.35 - 1.63);CODEX(HR = 1.42,95%CI 1.31 - 1.54);COTE(HR = 1.55,95%CI 1.36 - 1.75);ADO(HR = 1.41,95%CI 1.29 - 1.54);以及Charlson合并症指数(HR = 1.35,95%CI 1.22 - 1.48)。(4)结论:多维指标是评估COPD病程和预后的有用临床工具。这些指标可用于识别高死亡风险患者,并指导COPD患者的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b12f/10093710/f2cb5a88813f/diagnostics-13-01344-g001.jpg

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