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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
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
2014-09-01
DOI10.1590/S1806-37132014000500005
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
WOS记录号WOS:000343354900005
项目编号07010440052
资助机构Chinese Medical Association Special Fund for Research on Chronic Respiratory Diseases
引用统计
被引频次:3[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55159
专题北京大学第三临床医学院_呼吸科
作者单位Peking Univ, Hosp 3, Dept Resp Med, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
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.
APA Chang, Chun,Zhu, Hong,Shen, Ning,Han, Xiang,Chen, Yahong,&He, Bei.(2014).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.JORNAL BRASILEIRO DE PNEUMOLOGIA,40(5),495-503.
MLA Chang, Chun,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".JORNAL BRASILEIRO DE PNEUMOLOGIA 40.5(2014):495-503.
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