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与慢性阻塞性肺疾病加重住院患者死亡风险相关的因素:更新的范围综述。

Factors associated with risk of death in hospitalized patients for exacerbation of chronic obstructive pulmonary disease: an updated scoping review.

机构信息

Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.

Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy.

出版信息

Expert Rev Respir Med. 2024 Jun;18(6):435-445. doi: 10.1080/17476348.2024.2375426. Epub 2024 Jul 4.

Abstract

INTRODUCTION

The Exacerbation of Chronic Obstructive Pulmonary Disease (ECOPD), especially if leading to hospitalization, increases the risk of death. Our scoping review aims to identify updated mortality risk factors for both short- and long-term periods.

AREAS COVERED

A comprehensive search, covering the period from January 2013 to February 2024, was performed to identify eligible studies that consider factors associated with death in hospitalized ECOPD. We considered short-term mortality, up to one year (including in-hospital mortality, IHM) and long-term mortality over one year, without time limits. We excluded studies concerning the intensive care area.

EXPERT OPINION

We considered 38 studies, 32 and 8 reporting data about short- and long-term mortality, respectively. Two studies consider both periods. Several factors, some already known, others newly identified, have been evaluated and discussed. Some of these were related to the characteristics and severity of COPD (age, body mass index, lung impairment), and some considered the response to ECOPD. In this last context, we focused on the increasing role of biomarkers in predicting the mortality of patients, particularly IHM. Our factors associated with a worse prognosis may be helpful in clinical practice to identify patients at risk and, subsequently, determine a personalized approach.

摘要

简介

慢性阻塞性肺疾病(COPD)恶化(ECOPD),尤其是导致住院的情况,会增加死亡风险。我们的范围综述旨在确定短期和长期内与死亡率相关的更新风险因素。

涵盖领域

从 2013 年 1 月到 2024 年 2 月,我们进行了全面的检索,以确定考虑与住院 ECOPD 患者死亡相关因素的合格研究。我们考虑了短期死亡率,即 1 年内(包括院内死亡率,IHM)和 1 年以上的长期死亡率,没有时间限制。我们排除了涉及重症监护区的研究。

专家意见

我们考虑了 38 项研究,其中 32 项和 8 项分别报告了短期和长期死亡率的数据。有两项研究同时考虑了这两个时期。已经评估和讨论了几个已经确定的和新发现的因素。其中一些与 COPD 的特征和严重程度有关(年龄、体重指数、肺损伤),还有一些则考虑了对 ECOPD 的反应。在这方面,我们重点关注生物标志物在预测患者死亡率方面的作用越来越大,特别是 IHM。我们发现的与预后不良相关的因素可能有助于临床实践中识别高危患者,并随后确定个性化的治疗方法。

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