Hu Qihui, Chen Jie, Li Shengqi
Department of Emergency General, Yongkang First People's Hospital, Yongkang, Zhejiang, China.
Department of Respiratory and Critical Care Medicine, Yongkang First People's Hospital, Yongkang, Zhejiang, China.
Medicine (Baltimore). 2025 Mar 21;104(12):e41857. doi: 10.1097/MD.0000000000041857.
This retrospective study aimed to compare the predictive efficacy of the shortness of breath with daily activities (SOBDA) and ventilatory response to exercise questionnaire (VSRQ) in forecasting respiratory-related adverse events in elderly patients with chronic obstructive pulmonary disease (COPD) over a 6-month follow-up period post-discharge. A total of 92 COPD patients, treated according to the 2022 GOLD report and Chinese National COPD treatment guidelines, were enrolled. SOBDA and VSRQ scores were collected upon admission and assessed daily for the first 7 days. A random forest model was used to evaluate the predictive value of these scores in relation to respiratory adverse events, with a training/testing group split at a 4:1 ratio. Five patients were excluded due to loss to follow-up or death, resulting in 87 patients in the final analysis. The primary endpoint was the occurrence of COPD exacerbations and respiratory failure. The random forest model using VSRQ scores as the response variable outperformed the SOBDA model in terms of predictive accuracy (AUC: 0.84 vs 0.65) and error rate (21.74% vs 22%). Both models demonstrated high accuracy in predicting the absence of adverse events (VSRQ: 85.72%, SOBDA: 83.67%) but showed limited sensitivity in predicting their occurrence (VSRQ: 35%, SOBDA: 40%). The VSRQ questionnaire demonstrated superior predictive performance compared to SOBDA, suggesting that VSRQ may be a useful tool for identifying high-risk elderly COPD patients and guiding clinical decision-making. Further studies are needed to confirm these findings and explore the broader applicability of VSRQ in COPD prognosis.
这项回顾性研究旨在比较日常活动气短（SOBDA）和运动通气反应问卷（VSRQ）在预测慢性阻塞性肺疾病（COPD）老年患者出院后6个月随访期内呼吸相关不良事件方面的预测效能。共纳入了92例按照2022年全球慢性阻塞性肺疾病倡议（GOLD）报告和中国慢性阻塞性肺疾病国家治疗指南进行治疗的COPD患者。入院时收集SOBDA和VSRQ评分，并在最初7天每天进行评估。使用随机森林模型评估这些评分与呼吸不良事件的预测价值，训练组/测试组按4:1的比例划分。由于失访或死亡，5例患者被排除，最终分析纳入87例患者。主要终点是COPD急性加重和呼吸衰竭的发生。以VSRQ评分为响应变量的随机森林模型在预测准确性（曲线下面积：0.84对0.65）和错误率（21.74%对22%）方面优于SOBDA模型。两个模型在预测无不良事件方面都显示出较高的准确性（VSRQ：85.72%，SOBDA：83.67%），但在预测不良事件发生方面敏感性有限（VSRQ：35%，SOBDA：40%）。与SOBDA相比，VSRQ问卷显示出更好的预测性能，这表明VSRQ可能是识别高危老年COPD患者和指导临床决策的有用工具。需要进一步的研究来证实这些发现，并探索VSRQ在COPD预后中更广泛的适用性。
