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学科主题: 临床医学
题名:
Utility of the combination of serum highly-sensitive C-reactive protein level at discharge and a risk index in predicting readmission for acute exacerbation of COPD
作者: Chang, Chun; Zhu, Hong; Shen, Ning; Han, Xiang; Chen, Yahong; He, Bei
关键词: Pulmonary disease ; chronic obstructive/epidemiology ; Acute disease ; Acute-phase proteins ; Hospitalization ; Patient readmission ; inflammation
刊名: JORNAL BRASILEIRO DE PNEUMOLOGIA
发表日期: 2014-09-01
DOI: 10.1590/S1806-37132014000500005
卷: 40, 期:5, 页:495-503
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Respiratory System
研究领域[WOS]: Respiratory System
关键词[WOS]: OBSTRUCTIVE PULMONARY-DISEASE ; HOSPITALIZATION ; MORTALITY ; ADMISSION ; DYSPNEA
英文摘要:

Objective: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. Methods: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). Results: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D >= 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% Cl: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% Cl: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D >= 3 mg/L and GOLD category D; hsCRP-D >= 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. Conclusions: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination.

语种: 英语
所属项目编号: 07010440052
项目资助者: Chinese Medical Association Special Fund for Research on Chronic Respiratory Diseases
WOS记录号: WOS:000343354900005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55159
Appears in Collections:北京大学第三临床医学院_呼吸内科_期刊论文

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作者单位: Peking Univ, Hosp 3, Dept Resp Med, Beijing 100191, Peoples R China

Recommended Citation:
Chang, Chun,Zhu, Hong,Shen, Ning,et al. Utility of the combination of serum highly-sensitive C-reactive protein level at discharge and a risk index in predicting readmission for acute exacerbation of COPD[J]. JORNAL BRASILEIRO DE PNEUMOLOGIA,2014,40(5):495-503.
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