Salai Grgur, Tokić Vukan-Ćusa Tatjana, Vergles Mirna, Škrinjarić Cincar Sanda, Ostojić Jelena, Škoro Matea, Vrbica Žarko, Lozo Vukovac Emilija, Tudorić Neven, Vukić Dugac Andrea
Department of Pulmonology, Dubrava University Hospital, 10000 Zagreb, Croatia.
Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia.
J Clin Med. 2025 Apr 21;14(8):2855. doi: 10.3390/jcm14082855.
: Hospitalizations for acute exacerbations in patients with chronic obstructive pulmonary disease (AECOPD) are connected with considerable mortality and morbidity and have a great impact on healthcare costs. We aimed to identify potentially important characteristics that distinguish patients with AECOPD that required hospitalization between those that did not. : We performed a post hoc study of a previously conducted observational study assessing the discharge records of AECOPD patients who were either hospitalized or discharged directly from the emergency department (ED). : A total of N = 593 AECOPD patients (37.4% female) were included: N = 225 (37.9%) were hospitalized, while 368 (62.1%) were discharged from the ED. Patients had a mean age of 71 (±9.14) years. Further, 64.7% had arterial hypertension, and 60.4% of hospitalized and 42.1% of discharged patients had cardiovascular disease (excluding hypertension) ( < 0.001). In addition, 24% of hospitalized patients suffered from diabetes mellitus (vs. 16.8% of those discharged, = 0.042). Patients that were discharged had a higher median eosinophil count than hospitalized patients ( < 0.001). Among the 368 patients discharged from the ED, 23.6% visited the ED due to AECOPD, and 50.6% were hospitalized in the subsequent three months. Patients that had at least one AECOPD in the subsequent three months had significantly lower initial eosinophil counts than those that did not ( = 0.015). : Hospitalized AECOPD patients had a higher prevalence of pre-existing cardiovascular disease, diabetes mellitus and lower blood eosinophil counts. Patients that had subsequently visited ED in the following three months initially had lower blood eosinophil counts than those that did not make subsequent visits.
慢性阻塞性肺疾病急性加重（AECOPD）患者的住院治疗与相当高的死亡率和发病率相关，并且对医疗成本有很大影响。我们旨在确定区分需要住院治疗的AECOPD患者与不需要住院治疗的患者的潜在重要特征。：我们对先前进行的一项观察性研究进行了事后分析，该研究评估了因AECOPD住院或直接从急诊科（ED）出院的患者的出院记录。：总共纳入了N = 593例AECOPD患者（女性占37.4%）：N = 225例（37.9%）住院，而368例（62.1%）从ED出院。患者的平均年龄为71（±9.14）岁。此外，64.7%的患者患有动脉高血压，住院患者中有60.4%、出院患者中有42.1%患有心血管疾病（不包括高血压）（P < 0.001）。此外，24%的住院患者患有糖尿病（而出院患者中这一比例为16.8%，P = 0.042）。出院患者的嗜酸性粒细胞计数中位数高于住院患者（P < 0.001）。在从ED出院的368例患者中，23.6%因AECOPD就诊于ED，50.6%在随后三个月内住院。在随后三个月内至少发生一次AECOPD的患者，其初始嗜酸性粒细胞计数显著低于未发生AECOPD的患者（P = 0.015）。：住院的AECOPD患者先前存在心血管疾病、糖尿病的患病率较高，血液嗜酸性粒细胞计数较低。在随后三个月内再次就诊于ED的患者，其初始血液嗜酸性粒细胞计数低于未再次就诊的患者。
