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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,
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 investig...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Pneumologia e Tisiologia
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263330/ https://www.ncbi.nlm.nih.gov/pubmed/25410837 http://dx.doi.org/10.1590/S1806-37132014000500005 |
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author | Chang, Chun Zhu, Hong Shen, Ning Han, Xiang Chen, Yahong He, Bei |
author_facet | Chang, Chun Zhu, Hong Shen, Ning Han, Xiang Chen, Yahong He, Bei |
author_sort | Chang, Chun |
collection | PubMed |
description | 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% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 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. |
format | Online Article Text |
id | pubmed-4263330 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-42633302014-12-12 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 J Bras Pneumol Original Articles 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% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 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. Sociedade Brasileira de Pneumologia e Tisiologia 2014 /pmc/articles/PMC4263330/ /pubmed/25410837 http://dx.doi.org/10.1590/S1806-37132014000500005 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Chang, Chun Zhu, Hong Shen, Ning Han, Xiang Chen, Yahong He, Bei 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, |
title | 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,
|
title_full | 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,
|
title_fullStr | 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,
|
title_full_unstemmed | 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,
|
title_short | 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,
|
title_sort | 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, |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263330/ https://www.ncbi.nlm.nih.gov/pubmed/25410837 http://dx.doi.org/10.1590/S1806-37132014000500005 |
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