Respiratory investigation最新文献_第6页

Impact of atropine and hydroxyzine pretreatment in contemporary bronchoscopy 阿托品和羟嗪预处理对当代支气管镜检查的影响

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-20 DOI: 10.1016/j.resinv.2025.11.012

Kazuo Tsuchiya, Ryota Miyamoto, Tomo Tsunoda, Taisuke Ito, Takuro Akashi, Yoshiyuki Oyama, Masaki Ikeda

Background

Bronchoscopy is essential for diagnosing and managing respiratory diseases. However, secretions and airway reflexes can impair procedural quality and patient comfort. While anticholinergic pretreatment using agents such as atropine and hydroxyzine has historically mitigated these physiological responses, recent guidelines discourage their routine use because of concerns regarding hemodynamic changes and uncertain benefits. This study aimed to assess the efficacy of anticholinergic pretreatment during contemporary bronchoscopy.

Methods

We conducted a single-center, cross-sectional study comparing two cohorts of patients who underwent bronchoscopy with transbronchial and ultrasound-guided needle biopsies. Group A (n = 35) received pretreatment with intramuscular atropine (0.5 mg) and hydroxyzine (25 mg) between July 2022 and September 2023, while Group B (n = 35) underwent procedures without pretreatment between December 2024 and March 2025. Patient discomfort was evaluated using a visual analog scale. Propensity score adjustment with inverse probability of treatment weighting (IPTW) accounted for differences in baseline factors.

Results

Seventy patients were included (n = 35 per group). After IPTW adjustment, Group B reported greater distress from salivation and cough and lower willingness for repeat bronchoscopy (p = 0.03, p = 0.02, p = 0.001, respectively). Group B also showed higher use of lidocaine (p < 0.001). No significant differences in midazolam dosage or vital signs were observed among either group.

Conclusion

Anticholinergic pretreatment may reduce procedural discomfort, particularly that associated with secretions and airway reflexes, without evident adverse effects. Further randomized controlled trials are required to validate the role of pretreatment in contemporary bronchoscopy.

背景：支气管镜检查对于诊断和治疗呼吸系统疾病至关重要。然而，分泌物和气道反射会损害手术质量和患者舒适度。虽然使用阿托品和羟嗪等抗胆碱能预处理药物在历史上减轻了这些生理反应，但由于担心血流动力学变化和不确定的益处，最近的指南不鼓励常规使用这些药物。本研究旨在评估当代支气管镜检查中抗胆碱能预处理的疗效。方法：我们进行了一项单中心横断面研究，比较了两组接受支气管镜检查、经支气管和超声引导下穿刺活检的患者。A组（n = 35）在2022年7月至2023年9月期间接受了肌肉注射阿托品（0.5 mg）和羟嗪（25 mg）的预处理，而B组（n = 35）在2024年12月至2025年3月期间接受了没有预处理的手术。采用视觉模拟量表评估患者不适程度。倾向评分调整与治疗加权逆概率（IPTW）解释了基线因素的差异。结果共纳入70例患者，每组35例。调整IPTW后，B组患者的流涎和咳嗽症状加重，再次支气管镜检查意愿降低（p = 0.03, p = 0.02, p = 0.001）。B组的利多卡因使用率也较高（p < 0.001）。两组患者咪达唑仑剂量及生命体征无显著差异。结论抗胆碱能预处理可减少手术不适，特别是与分泌物和气道反射相关的不适，无明显不良反应。需要进一步的随机对照试验来验证预处理在当代支气管镜检查中的作用。

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引用次数: 0

High diagnostic yield and treatment impact of bronchoscopy in elderly lung cancer patients (≥ 80 years): A single-center retrospective study 老年肺癌患者（≥80岁）支气管镜检查的高诊断率和治疗效果：一项单中心回顾性研究

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-19 DOI: 10.1016/j.resinv.2025.101335

Shingo Maeda , Takuma Ina , Atsuhiko Ota , Masaaki Matsunaga , Tomoya Horiguchi , Aki Ikeda , Ryoma Moriya , Takaya Sato , Chiaki Sawada , Yuko Oya , Shotaro Okachi , Yasuhiro Goto , Sumito Isogai , Naozumi Hashimoto , Masashi Kondo , Kazuyoshi Imaizumi

Background

Although bronchoscopic biopsy serves as a cornerstone for diagnosing lung cancer in elderly patients, whether this procedure leads to clinically relevant outcomes is still unclear. This study aimed to clarify the clinical significance of diagnostic bronchoscopy in lung cancer patients aged ≥80 years.

Methods

We retrospectively analyzed 803 patients diagnosed with lung cancer who underwent bronchoscopy at our hospital from April 2015 to March 2019. Those aged ≥80 years and <80 years were classified as the elderly group (n = 154) and young group (n = 649), respectively.

Results

The diagnostic yield of bronchoscopy in the elderly and young groups was 92.9 % and 83.5 %, respectively; complication rates were 9.6 % and 7.2 %. Approximately 89 % of the patients in the elderly group received specific lung cancer treatment. The 5-year survival rates for elderly and young patients who underwent surgery were 74.5 % and 78.2 %, respectively. In the elderly group, 11 % of the patients chose best supportive care (BSC) only, compared with 2 % in the young group. Notably, patients with non-diagnostic bronchoscopic results selected BSC more frequently in the elderly versus young groups (30.4 % versus 0 %, respectively).

Conclusions

Bronchoscopy in elderly patients with lung cancer demonstrated a high diagnostic yield and an acceptable safety profile, enabling specific treatments in the majority of cases. These findings support the clinical usefulness of bronchoscopy in guiding treatment decisions for elderly patients. However, non-diagnostic results were associated with a higher likelihood of BCS, highlighting the importance of achieving a definitive diagnosis in this population.

背景：尽管支气管镜活检是诊断老年患者肺癌的基础，但该手术是否会导致临床相关的结果尚不清楚。本研究旨在阐明≥80岁肺癌患者诊断性支气管镜检查的临床意义。方法：回顾性分析2015年4月至2019年3月在我院行支气管镜检查的803例肺癌患者。≥80岁及结果：老年组支气管镜诊断率为92.9%，青年组为83.5%；并发症发生率分别为9.6%和7.2%。大约89%的老年组患者接受了特定的肺癌治疗。老年和年轻患者手术后的5年生存率分别为74.5%和78.2%。在老年组中，11%的患者只选择了最佳支持治疗（BSC），而在年轻组中，这一比例为2%。值得注意的是，非诊断性支气管镜检查结果的患者在老年人中比年轻人更频繁地选择BSC（分别为30.4%和0%）。结论：支气管镜检查在老年肺癌患者中具有较高的诊断率和可接受的安全性，可在大多数病例中进行特异性治疗。这些发现支持支气管镜检查在指导老年患者治疗决策中的临床应用。然而，非诊断性结果与BCS的可能性较高相关，强调了在该人群中获得明确诊断的重要性。

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引用次数: 0

Critical appraisal of “Effects of Daikin air purifiers on asthma control and pulmonary function: A multicenter, single-arm, observational pilot study” “大金空气净化器对哮喘控制和肺功能的影响：一项多中心、单臂、观察性初步研究”的批判性评价

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-18 DOI: 10.1016/j.resinv.2025.11.004

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Clinical characteristics and healthcare resource utilization among patients hospitalized for pulmonary tuberculosis: A national inpatient database study in Japan 肺结核住院患者的临床特征和医疗资源利用：日本国家住院患者数据库研究

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-17 DOI: 10.1016/j.resinv.2025.11.007

Jumpei Taniguchi , Shotaro Aso , Hiroki Matsui , Kiyohide Fushimi , Hideo Yasunaga

Background

In Japan, discharge for pulmonary tuberculosis requires microbiological confirmation of non-infectivity, leading to prolonged hospitalization. International guidelines increasingly support early discharge based on clinical stability. This study aimed to describe the clinical characteristics and healthcare utilization of hospitalized tuberculosis patients in Japan and to estimate the proportion potentially eligible for early discharge and associated cost savings.

Methods

This nationwide retrospective cohort study analyzed patients hospitalized for pulmonary tuberculosis, who received rifampicin and isoniazid within 7 days of admission. Data were extracted from an inpatient claims database between June 2010 and March 2023. Patients who met the following predefined clinical criteria were eligible for early discharge: absence of drug resistance, absence of severe comorbidities, and functional independence. Cost simulation was performed under the assumption that patients eligible for early discharge were discharged 14 days after treatment initiation.

Results

Overall, 22,634 patients were eligible. Their mean age was 71.1 years; approximately 40 % required some assistance with activities of daily living. The mean length of hospitalization was 59.2 days (standard deviation, 50.7); the median hospitalization cost was USD 8,974 (interquartile range, 5,696–14,706). Overall, 32.9 % of patients met the criteria for early discharge. Under the hypothetical early discharge scenario, the median estimated cost saving per patient was USD 4,625 (interquartile range, 2,332–8,560).

Conclusions

Early discharge may be feasible for a subset of hospitalized pulmonary tuberculosis patients in Japan and could contribute toward optimizing healthcare resource utilization by reducing hospitalization costs.

背景：在日本，肺结核的出院需要微生物学证实非传染性，导致住院时间延长。国际指南越来越多地支持基于临床稳定性的早期出院。本研究旨在描述日本住院结核病患者的临床特征和医疗保健利用情况，并估计可能符合早期出院条件的比例和相关的费用节约。方法本研究是一项全国性的回顾性队列研究，对住院7天内接受利福平和异烟肼治疗的肺结核患者进行分析。数据提取自2010年6月至2023年3月期间的住院患者索赔数据库。符合以下预定义临床标准的患者有资格提前出院：无耐药性，无严重合并症，功能独立。假设符合提前出院条件的患者在治疗开始后14天出院，进行成本模拟。结果共纳入22634例患者。平均年龄71.1岁；大约40%的患者在日常生活活动中需要一些帮助。平均住院时间59.2天（标准差50.7）；住院费用中位数为8,974美元（四分位数范围为5,696-14,706）。总体而言，32.9%的患者符合早期出院标准。在假设提前出院的情况下，每位患者节省的成本中位数为4,625美元（四分位数范围为2,332-8,560）。结论日本部分住院肺结核患者早期出院是可行的，可以通过降低住院费用来优化医疗资源利用。

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引用次数: 0

Impact of the COVID-19 pandemic on acute exacerbation of idiopathic pulmonary fibrosis: a nationwide observational study in Japan 新冠肺炎大流行对特发性肺纤维化急性加重的影响：日本一项全国性观察性研究

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-17 DOI: 10.1016/j.resinv.2025.11.005

Yuichi Ohteru , Tomoyuki Kakugawa , Masahiro Kakugawa , Tsunahiko Hirano , Kazuto Matsunaga

Background

The coronavirus disease 2019 (COVID-19) pandemic and associated infection control measures drastically reduced respiratory infections worldwide. This unique context facilitated a natural investigation of the role of respiratory infections in triggering acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). The aim of this study was to evaluate changes in AE-IPF incidence, seasonality, and prognosis before and during the pandemic using a nationwide Japanese database.

Methods

This retrospective cohort study was based on hospitalization data from April 1, 2018 to March 31, 2022. Pandemic-related changes in AE-IPF incidence, seasonal trends, and outcomes were assessed with respect to the pre-pandemic period using mixed-design analysis of variance and Kaplan–Meier survival analysis. For comparison, similar changes in chronic obstructive pulmonary disease (COPD) exacerbation were examined using the same methods.

Results

Despite reduced respiratory infections, AE-IPF incidence did not decrease during the pandemic. While the typical winter surge in respiratory infections disappeared during the pandemic, the seasonal increase in AE-IPF incidence during winter persisted. However, the incidence of COPD exacerbations decreased significantly, and the seasonality of exacerbations shifted during the pandemic.

Conclusions

The findings of this study question the prior assumption that respiratory infections are key contributors to AE-IPF. While respiratory infections may play a role in some cases, our results suggest that, at least for pre-pandemic respiratory infections, their overall contribution may be less substantial than that previously assumed. This underscores the need to reconsider the pathogenesis of AE-IPF and explore noninfectious mechanisms with regard to its management.

2019冠状病毒病（COVID-19）大流行和相关的感染控制措施大大减少了全世界的呼吸道感染。这种独特的背景促进了对呼吸道感染在引发特发性肺纤维化急性加重（AE-IPF）中的作用的自然调查。本研究的目的是利用日本全国数据库评估AE-IPF发病率、季节性和预后在大流行之前和期间的变化。方法回顾性队列研究基于2018年4月1日至2022年3月31日的住院数据。采用混合设计方差分析和Kaplan-Meier生存分析，评估大流行前AE-IPF发病率、季节性趋势和结局的大流行相关变化。为了比较，使用相同的方法检查慢性阻塞性肺疾病（COPD）恶化的类似变化。结果大流行期间，尽管呼吸道感染有所减少，但AE-IPF发病率并未下降。虽然冬季呼吸道感染的典型激增在大流行期间消失了，但AE-IPF发病率在冬季的季节性增加仍在继续。然而，COPD急性发作的发生率显著下降，并且在大流行期间急性发作的季节性发生了变化。结论本研究的发现质疑了先前的假设，即呼吸道感染是AE-IPF的关键因素。虽然呼吸道感染可能在某些情况下起作用，但我们的研究结果表明，至少在大流行前的呼吸道感染中，它们的总体贡献可能没有以前假设的那么大。这强调需要重新考虑AE-IPF的发病机制，并探索其管理的非感染性机制。

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引用次数: 0

The role of ultrasound-guided cervical lymph node biopsy in lung cancer: A scoping review 超声引导下颈部淋巴结活检在肺癌中的作用：范围回顾

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-17 DOI: 10.1016/j.resinv.2025.11.010

L. Thong , C. Daneshvar , M. Hassan , D. Breen

The involvement of cervical lymph nodes in lung cancer occurs frequently. Despite the involvement of this group of lymph nodes reflecting either stage N3 or M1b in patients with non-small cell lung cancer, they do not receive the same amount of attention as mediastinal lymph nodes. Furthermore, these lymph nodes are more accessible for histology samples compared to other group of lymph nodes. Critically, cervical lymph nodes are often missed on CT scans. Neck US and US-guided biopsy of cervical lymph nodes have more established roles in other primary malignancies (e.g. thyroid cancer) and non-malignant diseases. This scoping review explores existing literature on neck US and cervical lymph node biopsy in patients with suspected lung cancer. The role and potentials benefits of neck US and cervical lymph node biopsy in this group of patients is examined. We also explored whether the procedure is being performed routinely by respiratory physicians as part of their lung cancer algorithm.

肺癌中颈部淋巴结的累及是很常见的。尽管这组淋巴结在非小细胞肺癌患者中反映了N3期或M1b期，但它们没有得到与纵隔淋巴结相同的重视。此外，与其他淋巴结组相比，这些淋巴结更容易获得组织学样本。关键的是，颈部淋巴结在CT扫描中经常被遗漏。颈部超声和超声引导下的颈部淋巴结活检在其他原发性恶性肿瘤（如甲状腺癌）和非恶性疾病中有更明确的作用。本综述探讨了疑似肺癌患者的颈部超声检查和颈部淋巴结活检的现有文献。颈部US和颈部淋巴结活检在这组患者中的作用和潜在的好处进行了检查。我们还探讨了呼吸内科医生是否将该手术作为其肺癌治疗方案的一部分进行常规治疗。

引用次数: 0

Impact of pneumothorax on clinical course of patients with amyotrophic lateral sclerosis on long-term ventilation 气胸对肌萎缩侧索硬化症长期通气患者临床病程的影响

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-17 DOI: 10.1016/j.resinv.2025.11.008

Nobuhiro Okagaki , Tomomasa Tsuboi , Yuichi Chihara , Kensuke Sumi , Hiroki Takeuchi , Kenji Yamamoto , Takashi Hajiro , Atsuo Sato

Background

Numerous clinical studies have shown that long-term positive pressure ventilation (PPV) improves quality of life and prognosis in patients with amyotrophic lateral sclerosis (ALS). Pneumothorax is an important complication of PPV; however, few studies investigated pneumothorax in patients with ALS on long-term PPV.

Methods

This retrospective longitudinal cohort study included 85 patients with ALS treated from 2013 to 2024. We collected information from medical records on ALS and pneumothorax treatment, blood laboratory data, radiology data, equipment data, and mortality. Subsequently, we compared clinical parameters and prognosis between the pneumothorax and non-pneumothorax groups.

Results

Of the 85 patients, 61 underwent long-term PPV. Nine patients developed pneumothorax following the initiation of long-term PPV. In contrast, 24 patients without long-term PPV did not experience pneumothorax. Among patients who received tracheostomy PPV as a maximum respiratory management, the pneumothorax group tended to have a poorer prognosis from ALS onset than the non-pneumothorax group. Moreover, the pneumothorax group had higher inspiratory positive airway pressure and support pressure of ventilator settings than the non-pneumothorax group. Among the nine pneumothorax cases, there were no deaths directly related to the complication, two patients who developed pneumothorax during non-invasive PPV transitioned to tracheostomy PPV as a result of the complication.

Conclusions

Pneumothorax should be recognized as a serious complication that can occur in patients with ALS on PPV. Higher inspiratory positive airway pressure and support pressure settings on long-term PPV may be significant risk factors for pneumothorax.

大量临床研究表明，长期正压通气（PPV）可改善肌萎缩侧索硬化症（ALS）患者的生活质量和预后。气胸是PPV的重要并发症；然而，很少有研究调查长期PPV对ALS患者气胸的影响。方法回顾性纵向队列研究纳入2013 - 2024年接受治疗的85例ALS患者。我们收集了有关ALS和气胸治疗的医疗记录、血液实验室数据、放射学数据、设备数据和死亡率的信息。随后，我们比较了气胸组和非气胸组的临床参数和预后。结果85例患者中，61例接受了长期PPV治疗。9例患者在开始长期PPV治疗后发生气胸。相比之下，没有长期PPV的24例患者没有发生气胸。在接受气管切开术PPV作为最大呼吸管理的患者中，气胸组在ALS发病后的预后往往比非气胸组差。气胸组吸气气道正压和呼吸机支持压力均高于非气胸组。在9例气胸病例中，没有与并发症直接相关的死亡，2例在无创PPV期间发生气胸的患者由于并发症而过渡到气管造口PPV。结论肺气胸是肌萎缩侧索硬化症患者在PPV治疗过程中可能发生的严重并发症。长期PPV患者较高的吸气气道正压和支持压力设置可能是气胸的重要危险因素。

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引用次数: 0

Successful treatment of huntingtin-interacting protein-1-anaplastic lymphoma kinase-positive lung cancer with severe airway stenosis using silicone stent placement and alectinib 应用硅胶支架和阿勒替尼成功治疗伴严重气道狭窄的亨廷顿蛋白相互作用蛋白-1间变性淋巴瘤激酶阳性肺癌。

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-01 DOI: 10.1016/j.resinv.2025.11.006

Yuma Sato , Hidenori Kitai , Yuta Takashima , Naofumi Shinagawa , Jun Sakakibara-Konishi , Hiroya Ohkawa , Kanako C. Hatanaka , Yutaka Hatanaka , Hiroshi Yokouchi , Satoshi Konno

Huntingtin-interacting protein 1 (HIP1)-anaplastic lymphoma kinase (ALK) is a relatively rare fusion in ALK-positive lung cancers. HIP1-ALK (H19:A20) is a rare variant among HIP1-ALK-positive lung cancers, and data on the efficacy of ALK tyrosine kinase inhibitors are limited. We report a 37-year-old man with HIP1-ALK (H19:A20) lung adenocarcinoma treated with silicone stent placement and alectinib. Stent placement was effective in improving symptoms, and the best treatment response with alectinib was a partial response. Routine ALK screening using IHC or comprehensive genomic profiling should be considered for patients with lung cancer with suspected ALK gene.

亨廷顿蛋白相互作用蛋白1 (HIP1)-间变性淋巴瘤激酶（ALK）是ALK阳性肺癌中相对罕见的融合。HIP1-ALK （H19:A20）在HIP1-ALK阳性肺癌中是一种罕见的变异，关于ALK酪氨酸激酶抑制剂疗效的数据有限。我们报告一例37岁男性HIP1-ALK （H19:A20）肺腺癌患者接受硅胶支架置入和alectiinib治疗。支架置入在改善症状方面是有效的，使用阿勒替尼的最佳治疗反应是部分反应。对于怀疑ALK基因的肺癌患者，应考虑采用免疫组化或综合基因组谱法进行常规ALK筛查。

引用次数: 0

Exacerbation and cardiopulmonary risk after prompt initiation of single-inhaler budesonide /glycopyrrolate/formoterol fumarate following COPD exacerbations: Insights from MITOS EROS (Japan) study 慢性阻塞性肺病（COPD）加重后立即开始使用单吸入器布地奈德/甘罗酸酯/富马酸福莫特罗后的加重和心肺风险：来自MITOS EROS（日本）研究的见解

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-01 DOI: 10.1016/j.resinv.2025.10.015

Koichiro Takahashi , Yuri Yoshida , Naoyuki Makita , Kenichiro Nishida , Michihiro Yoshimura , Zhao Cheng , Aaro Salosensaari , Catarina Camarinha , Reiko Yamaura , Marta Cuntin , Michael Pollack

Background

Previous evidence supported prompt initiation of single-inhaler triple therapy in chronic obstructive pulmonary disease (COPD), but data specific to Japan are lacking. This study investigated the association between budesonide/glycopyrrolate/formoterol fumarate (BGF) initiation and subsequent COPD exacerbations or severe cardiopulmonary events in Japanese patients initiating BGF following previous exacerbations.

Methods

This was an observational cohort study among patients with COPD using IQVIA Integrated claims data. Between BGF launch (September 2019) and March 2023, patients aged ≥40 years initiating BGF following COPD exacerbations (index) were included. Patients were categorized into BGF initiation groups by treatment initiation timing following index exacerbations: prompt (≤30 days), delayed (31–180 days), and very delayed (181–365 days). Multivariable negative binomial regression models evaluated the associations between BGF initiation strategies and subsequent exacerbations or severe cardiopulmonary events.

Results

3402 eligible patients were included: 840 prompt, 1143 delayed, and 1419 very delayed BGF initiators. The crude COPD exacerbation event rate (95 % confidence interval [CI]) per person-year was 1.66 (1.58–1.74) for prompt, 2.36 (2.30–2.43) for delayed, and 2.60 (2.54–2.66) for very delayed initiators during follow-up. Compared to prompt initiation, delayed (adjusted rate ratio [RR]: 1.25; 95 % CI: 1.13–1.38) and very delayed (adjusted RR: 1.09; 95 % CI: 0.99–1.20) BGF initiation showed an increased risk of COPD exacerbations. No associations were observed between BGF initiation strategies and severe cardiopulmonary events.

Conclusion

Following COPD exacerbations, initiating BGF promptly was associated with reduction in subsequent exacerbations. Patients should receive prompt and proactive treatment to reduce COPD morbidity.

背景：先前的证据支持慢性阻塞性肺疾病（COPD）的单吸入器三联疗法的迅速启动，但缺乏日本特有的数据。本研究调查了布地奈德/甘罗酸酯/富马酸福莫特罗（BGF）启动与随后COPD加重或严重心肺事件的关系，这些患者在既往加重后启动BGF。方法：这是一项使用IQVIA综合索赔数据的COPD患者观察性队列研究。在BGF推出（2019年9月）至2023年3月期间，纳入年龄≥40岁的COPD加重（指数）后开始BGF的患者。根据指标加重后的治疗起始时间将患者分为BGF起始组：提示（≤30天）、延迟（31-180天）和非常延迟（181-365天）。多变量负二项回归模型评估了BGF启动策略与随后的恶化或严重心肺事件之间的关系。结果：纳入3402例符合条件的患者：840例及时启动，1143例延迟启动，1419例非常延迟启动。随访期间，急性COPD患者的年均急性加重发生率（95%可信区间[CI]）为：即刻者1.66(1.58-1.74)，迟发者2.36(2.30-2.43)，迟发者2.60（2.54-2.66）。与立即启动相比，延迟启动（调整后的比率比[RR]: 1.25; 95% CI: 1.13-1.38）和非常延迟启动（调整后的RR: 1.09; 95% CI: 0.99-1.20）的BGF显示COPD加重的风险增加。未观察到BGF起始策略与严重心肺事件之间的关联。结论：COPD加重后，及时启动BGF与随后加重的减少相关。患者应及时接受积极治疗以降低COPD发病率。

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引用次数: 0

Caregiver burden among caregivers of patients receiving home oxygen therapy: Insights of the Japanese White Paper on Home Respiratory Care 2024 接受家庭氧气治疗的患者的护理人员负担：日本家庭呼吸护理白皮书2024的见解

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-01 DOI: 10.1016/j.resinv.2025.10.011

Satoshi Hamada , Jun Ueki , Toyohiro Hirai , Emika Sano , Keiko Hino , Megumi Ikeda , Susumu Sato , Toru Oga , Tomomasa Tsuboi , Hajime Kurosawa , Hiroo Wada , Japanese White Paper on Home Respiratory Care 2024 working group

Background

The factors influencing caregiver burden in Japan remained understudied, particularly in nationwide surveys. Japan is among the countries experiencing the most rapid population aging and declining birth rates. Herein, we examined caregiver burden and the related factors in caregivers of patients receiving home oxygen therapy (HOT) based on data from the Japanese White Paper on Home Respiratory Care 2024.

Methods

Patients receiving HOT who responded to the Short Form-8 (SF-8) questionnaire comprised two summary scores (physical [PCS] and mental component summaries [MCS]) and caregivers of these patients who responded to the SF-8 questionnaire and the Burden Index of Caregiver-11 (BIC-11) questionnaire were included in the analysis.

Results

A total of 102 caregiver−patient pairs were included; the median age was 72 and 74 years, respectively. The BIC-11 total score in caregivers providing <3 h of daily care was significantly lower than that in those providing ≥3 h (p < 0.0001). Stepwise multiple linear regression analysis identified the following independent predictors of the BIC-11 total score: among caregivers, daily caregiving hours (β = 0.16, p = 0.043), PCS (β = −0.29, p = 0.0001), and MCS (β = −0.53, p < 0.0001); and among patients, male sex (β = 0.22, p = 0.020), a modified Medical Research Council score of 4 (β = 0.20, p = 0.048), and daily walking and exercising (β = −0.23, p = 0.027).

Conclusions

This study identified key factors associated with caregiver burden in HOT.

背景：影响日本照顾者负担的因素仍未得到充分研究，特别是在全国性调查中。日本是人口老龄化和出生率下降最快的国家之一。本文基于日本家庭呼吸护理白皮书2024的数据，研究了接受家庭氧疗（HOT）患者的护理人员负担及其相关因素。方法：对接受HOT治疗的患者进行SF-8 （Short Form-8, SF-8）问卷调查，该问卷由两部分综合得分（physical components summaries， PCS）和mental components summaries （mental components summaries， MCS）组成，并对填写SF-8问卷和BIC-11问卷的患者的护理人员进行分析。结果：共纳入102对护理者-患者；中位年龄分别为72岁和74岁。结论：本研究确定了与护理人员负担相关的关键因素。

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引用次数: 0