[1]许能銮,郑建狮,陈愉生,等.慢性阻塞性肺疾病急性加重期205例出院后1年内死亡的相关因素分析[J].福建医药杂志,2022,44(01):18-23.
　XU Nengluan,ZHENG Jianshi,CHEN Yusheng,et al.Analysis of factors related to the death within one year after discharge in 205 patients with acute exacerbation of chronic obstructive pulmonary disease[J].FUJIAN MEDICAL JOURNAL,2022,44(01):18-23.
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慢性阻塞性肺疾病急性加重期205例出院后1年内死亡的相关因素分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期数:
2022年01期
页码:
18-23
栏目:
临床研究
出版日期:
2022-02-15

文章信息/Info

Title:
Analysis of factors related to the death within one year after discharge in 205 patients with acute exacerbation of chronic obstructive pulmonary disease
文章编号:
1002-2600(2022)01-0018-06
作者:
许能銮; 郑建狮; 陈愉生; 李小钦
福建医科大学省立临床医学院福建省立医院呼吸与危重症医学科(福州350001)
Author(s):
XU Nengluan;  ZHENG Jianshi;  CHEN Yusheng;  LI Xiaoqin
Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China
关键词:
慢性阻塞性肺疾病急性加重期; 死亡风险; 独立危险因素; 保护因素; 预测模型
Keywords:
acute exacerbation of chronic obstructive pulmonary disease;  death risk;  independent risk factors;  protective factors;  predictive model
分类号:
R563.9
文献标志码:
B
摘要:
目的 探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of COPD，AECOPD)住院患者出院后1年内死亡的相关因素。方法 收集我院2019年1月至2020年1月期间诊断为“AECOPD”的住院患者的临床资料。对患者进行电话回访，根据其出院后1年内的生存情况分为死亡组(37例，18%)和非死亡组(168例，82%)。进行多因素logistic回归分析，并构建预测模型，绘制ROC (receiver operator characteristic) 曲线评估模型预测效果。结果 上1年急性加重次数≥2次[OR=23.361，95% CI (4.621，78.213)，P<0.001]、呼吸困难指数量表>2级[OR=29.197，95% CI (3.578，122.091)，P=0.001]、痰培养检出铜绿假单胞菌[OR=20.242，95% CI (2.303，1321.671)，P=0.0013]、心脏彩超提示右心室增大[OR=3.318，95% CI (1.653，32.552)，P=0.009] 是AECOPD住院患者出院后1年内死亡的危险因素;长期家庭氧疗(long term oxygen therapy, LTOT) [OR=0.153，95% CI (0.007，0.159)，P<0.001] 是保护因素。经ROC验证，当预测界值为0.508时，本模型的敏感度为75.0%，特异度为94.0%，约登指数为0.69，ROC曲线下面积为0.960。结论 上1年急性加重次数≥2次、呼吸困难指数量表>2级、痰培养检出铜绿假单胞菌、心脏彩超提示右心室增大的AECOPD住院患者出院后1年内死亡风险高;长期家庭氧疗可以减少死亡风险。
Abstract:
Objective To explore the relevant factors of death within one year after discharge in 205 patients with the acute exacerbation of COPD. Methods The clinical data from patients diagnosed with “acute exacerbation of chronic obstructive pulmonary disease (AECOPD)” from January 2019 to January 2020 were collected. The patients included in the study were in terviewed by telephone. According to their survival within one year after discharge, the patients were divided into a death group of 37 cases (18%) and a non death group of 168 cases (82%). Binary multivariate logistic regression was conducted and the predictive models were built, the receiver operator characteristic (ROC) curves were drawn to evaluate the effect of the model prediction. Results Acute exacerbation in the last year before admission over twice, modified Medical Research Council dyspnea index scores over level two，detection of pseudomonas aeruginosa in sputum culture, indicating enlargement of the right ventricle by echocardiography were the risk factors to AECOPD inpatients death within one year after discharge. Long term oxygen therapy was a protective factor. As verified by ROC，when the threshold was 0.508，the model's sensitivity was 75.0%，the specificity was 94.0%，and the Youden Index was 0.69. Area under the ROC curve was 0.960. Conclusion The patients with AECOPD who were with acute exacerbation over twice in the last year before admission，or with modified Medical Research Council dyspnea index scores over level two, or with detection of pseudomonas aeruginosa in sputum culture, or with enlargement of the right ventricle have a higher mortality rate within one year after discharge. Long term oxygen therapy can reduce the mortality.

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备注/Memo

备注/Memo:
基金项目:福建省科技厅引导性项目(2018Y0010); 福建省卫计委医学创新课题(2017-CX-5)
更新日期/Last Update: 2022-02-15