摘要
目的 分析慢性阻塞性肺疾病急性加重(AECOPD)患者出院30天内再次加重入院与长期不良预后的相关性。方法 选取2019年1月至2022年7月的AECOPD患者205例,出院后30天内再次加重入院患者为观察组32例(15.61%),其余为对照组173例(84.39%),比较两组人口学及临床资料、2年内加重和再入院累计发生率和发病密度,分析出院30天内再次加重入院与长期不良预后的相关性。结果 观察组过去1年急性加重、家庭氧疗和入院时CAT评分≥10分比率高于对照组,FEV_1%预测值低于对照组。观察组PaCO_(2)和中性粒细胞水平,呼吸衰竭、肺炎和肺源性心脏病比率,应用全身糖皮质激素、甲基黄嘌呤和抗生素治疗均高于对照组。观察组30天内再次入院中位时间19(10,25)天,30天随访观察组mMRC评分≥2分、CAT评分≥10分和家庭氧疗比率高于对照组。观察组急性加重和全因再入院的发病密度和累计发病率均高于对照组。出院30天内再次加重入院是2年内急性加重和全因再入院的相关因素。结论 出院30天内再次加重入院是AECOPD患者2年内急性加重和全因再入院的重要预测因素。
Objective To analyze the correlation between re-admission within 30 days of discharge and long-term adverse prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 205 patients with AECOPD from January 2019 to July 2022 were selected.32 cases(15.61%)with re-aggravation within 30 days after discharge were included in the observation group,and the rest 173 cases(84.39%)were included in the control group.Demographic and clinical data,cumulative incidence and density of exacerbation and readmission within 2 year were compared between the two groups,and the correlation between readmission within 30 days of discharge and long-term adverse prognosis was analyzed.Results The incidence of acute exacerbation,home oxygen therapy,and CAT score≥10 at admission in the observation group over the past year was higher than that in the control group,and the predicted FEV_(1)%was lower than that in the control group.The levels of PaCO_(2) and neutrophils in the observation group,as well as the rates of respiratory failure,pneumonia,and pulmonary heart disease,were higher than those in the control group when treated with systemic glucocorticoids,methylxanthine,and antibiotics.The median time for readmission within 30 days in the observation group was 19(10,25)days.During the 30-day follow-up,the observation group had an mMRC score of≥2,a CAT score of≥10,and a higher rate of home oxygen therapy than the control group.The incidence density and cumulative incidence rate of acute exacerbation and all-cause readmission in the observation group were higher than those in the control group.Re-admission within 30 days of discharge was a related factor for acute exacerbation within 2 years and all-cause readmission.Conclusion Readmission within 30 days of discharge is an important predictive factor for acute exacerbation and all-cause readmission in AECOPD patients within 2 years.
作者
徐晓波
石磊
XU Xiaobo;SHI Lei(Department of Respiratory,Hefei Eighth People′s Hospital,Hefei,Anhui 238000,China)
出处
《临床肺科杂志》
2024年第9期1380-1384,共5页
Journal of Clinical Pulmonary Medicine
关键词
慢性阻塞性肺疾病
急性加重期
预后
相关性分析
chronic obstructive pulmonary disease
acute exacerbation period
prognosis
correlation analysis
