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Predictors of poor clinical outcomes including in-hospital death and low ability to perform activities of daily living at discharge in hospitalized patients with chronic obstructive pulmonary disease exacerbation
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Many patients with COPD experience exacerbations that require hospitalization, which is associated with an increased risk of in-hospital death and impaired ability to perform activities of...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214045/ https://www.ncbi.nlm.nih.gov/pubmed/37218674 http://dx.doi.org/10.1177/17534666231172924 |
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author | Murakami, Yurina Yasui, Hideki Sato, Jun Uto, Tomohiro Inui, Naoki Suda, Takafumi Imokawa, Shiro |
author_facet | Murakami, Yurina Yasui, Hideki Sato, Jun Uto, Tomohiro Inui, Naoki Suda, Takafumi Imokawa, Shiro |
author_sort | Murakami, Yurina |
collection | PubMed |
description | BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Many patients with COPD experience exacerbations that require hospitalization, which is associated with an increased risk of in-hospital death and impaired ability to perform activities of daily living (ADL). Declining ability to perform ADL is a critical issue for these patients. OBJECTIVES: To identify predictors of poor clinical outcomes, including in-hospital death and low ability to perform ADL at discharge, in patients who are hospitalized with exacerbation of COPD. DESIGN: This retrospective study involved a cohort of patients with exacerbation of COPD who were admitted to Iwata City Hospital in Japan between July 2015 and October 2019. METHODS: We collected clinical data, measured the cross-sectional area of the erector spinae muscles (ESM(CSA)) on computed tomography (CT) scans at admission, and investigated the associations of poor clinical outcomes (in-hospital death and severe dependence when performing ADL, defined as a Barthel Index (BI) of ⩽40 at discharge) with clinical parameters. RESULTS: Overall, 207 patients were hospitalized for exacerbation of COPD during the study period. The incidence of poor clinical outcomes was 21.3%, and the in-hospital mortality rate was 6.3%. Multivariate logistic regression analyses showed that older age, long-term oxygen therapy, an elevated D-dimer concentration, and a reduced ESM(CSA) on chest CT at admission were significantly associated with poor clinical outcomes (in-hospital death and a BI of ⩽40). CONCLUSION: Hospitalization for exacerbation of COPD was associated with high rates of in-hospital mortality and a BI of ⩽40 at discharge, which may be predicted by assessment of ESM(CSA). |
format | Online Article Text |
id | pubmed-10214045 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-102140452023-05-27 Predictors of poor clinical outcomes including in-hospital death and low ability to perform activities of daily living at discharge in hospitalized patients with chronic obstructive pulmonary disease exacerbation Murakami, Yurina Yasui, Hideki Sato, Jun Uto, Tomohiro Inui, Naoki Suda, Takafumi Imokawa, Shiro Ther Adv Respir Dis Original Research BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Many patients with COPD experience exacerbations that require hospitalization, which is associated with an increased risk of in-hospital death and impaired ability to perform activities of daily living (ADL). Declining ability to perform ADL is a critical issue for these patients. OBJECTIVES: To identify predictors of poor clinical outcomes, including in-hospital death and low ability to perform ADL at discharge, in patients who are hospitalized with exacerbation of COPD. DESIGN: This retrospective study involved a cohort of patients with exacerbation of COPD who were admitted to Iwata City Hospital in Japan between July 2015 and October 2019. METHODS: We collected clinical data, measured the cross-sectional area of the erector spinae muscles (ESM(CSA)) on computed tomography (CT) scans at admission, and investigated the associations of poor clinical outcomes (in-hospital death and severe dependence when performing ADL, defined as a Barthel Index (BI) of ⩽40 at discharge) with clinical parameters. RESULTS: Overall, 207 patients were hospitalized for exacerbation of COPD during the study period. The incidence of poor clinical outcomes was 21.3%, and the in-hospital mortality rate was 6.3%. Multivariate logistic regression analyses showed that older age, long-term oxygen therapy, an elevated D-dimer concentration, and a reduced ESM(CSA) on chest CT at admission were significantly associated with poor clinical outcomes (in-hospital death and a BI of ⩽40). CONCLUSION: Hospitalization for exacerbation of COPD was associated with high rates of in-hospital mortality and a BI of ⩽40 at discharge, which may be predicted by assessment of ESM(CSA). SAGE Publications 2023-05-23 /pmc/articles/PMC10214045/ /pubmed/37218674 http://dx.doi.org/10.1177/17534666231172924 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Murakami, Yurina Yasui, Hideki Sato, Jun Uto, Tomohiro Inui, Naoki Suda, Takafumi Imokawa, Shiro Predictors of poor clinical outcomes including in-hospital death and low ability to perform activities of daily living at discharge in hospitalized patients with chronic obstructive pulmonary disease exacerbation |
title | Predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
title_full | Predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
title_fullStr | Predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
title_full_unstemmed | Predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
title_short | Predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
title_sort | predictors of poor clinical outcomes including in-hospital death and
low ability to perform activities of daily living at discharge in hospitalized
patients with chronic obstructive pulmonary disease exacerbation |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214045/ https://www.ncbi.nlm.nih.gov/pubmed/37218674 http://dx.doi.org/10.1177/17534666231172924 |
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