BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exac...BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.展开更多
目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者抑郁状况及与临床情况的相关性。方法选择2014年1月-2015年2月354例老年住院COPD患者,通过医院焦虑抑郁情绪测量表(hospital anxiety and depression sca...目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者抑郁状况及与临床情况的相关性。方法选择2014年1月-2015年2月354例老年住院COPD患者,通过医院焦虑抑郁情绪测量表(hospital anxiety and depression scale,HAD)进行抑郁状态评估,收集临床资料和肺功能数据并进行相关分析。结果 354例老年住院COPD患者中,抑郁组(HAD≥11分)306例,非抑郁组(HAD<11分)48例。抑郁组和非抑郁组患者年龄、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、慢性阻塞性肺疾病评估测试(COPD assessment test,CAT)差异无统计学意义(P>0.05);抑郁组患者体质指数(body mass index,BMI)、急性加重次数、FEV1%pred高于非抑郁组(均P<0.05)。相关分析提示CAT和抑郁评分呈正相关(r=0.44,P=0.011);年龄和抑郁评分无相关性(r=0.025,P=0.861);BMI、FEV1%pred和抑郁呈负相关(r=-0.467,P=0.007;r=-0.28,P=0.02)。结论老年住院COPD患者抑郁发病率高,其发生与CAT呈正相关,与BMI、FEV1%pred呈负相关。展开更多
基金supported by grants from Dongzhimen Hospital Fund of Special Talent(2018RC01)Beijing University of Chinese Medicine Fund of Project(2019-JYB-XJSJJ-025)
文摘BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.
文摘目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者抑郁状况及与临床情况的相关性。方法选择2014年1月-2015年2月354例老年住院COPD患者,通过医院焦虑抑郁情绪测量表(hospital anxiety and depression scale,HAD)进行抑郁状态评估,收集临床资料和肺功能数据并进行相关分析。结果 354例老年住院COPD患者中,抑郁组(HAD≥11分)306例,非抑郁组(HAD<11分)48例。抑郁组和非抑郁组患者年龄、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、慢性阻塞性肺疾病评估测试(COPD assessment test,CAT)差异无统计学意义(P>0.05);抑郁组患者体质指数(body mass index,BMI)、急性加重次数、FEV1%pred高于非抑郁组(均P<0.05)。相关分析提示CAT和抑郁评分呈正相关(r=0.44,P=0.011);年龄和抑郁评分无相关性(r=0.025,P=0.861);BMI、FEV1%pred和抑郁呈负相关(r=-0.467,P=0.007;r=-0.28,P=0.02)。结论老年住院COPD患者抑郁发病率高,其发生与CAT呈正相关,与BMI、FEV1%pred呈负相关。
