慢性阻塞性肺病急性加重急诊科患者住院的预测因素——土耳其的一项单中心研究

Tuğba Sanalp Menekşe, Ekrem Taha Sert
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介绍和目的。在这项研究中,我们评估了可能与急诊科(ED)慢性阻塞性肺疾病(AECOPD)急性加重患者住院相关的参数。材料和方法。在2020年1月1日至2021年12月31日期间,因AECOPD而出现ED的COPD患者被纳入研究。患者数据来自医院数据库。采用单变量和多变量logistic回归方法确定住院与临床参数之间的关系。结果。研究纳入237例患者,分为两组:住院患者124例,门诊患者113例。我们发现两组患者在体温、氧饱和度、呼吸频率、c反应蛋白、白细胞计数、降钙素原、白蛋白、动脉血pH、pco2和无创机械通气(NIMV)需求方面存在显著差异。多变量logistic回归分析显示体温[比值比(OR):1.62;95%可信区间(CI): 1.21-4.91;p < 0.01)、血氧饱和度(OR:0.73, 95% CI:0.39-0.94, p < 0.001)、呼吸速率(OR:1.96;95% ci: 1.07-6.14;p<0.001),白蛋白(OR:0.71;95%置信区间:0.41—-0.93;p=0.042),降钙素原(OR:2.93;95%置信区间:1.22—-4.84;p<0.001),动脉血pH值(OR:0.78;95%置信区间:0.29—-0.91;p=0.038), pco2 (OR:2.45;95%置信区间:1.24—-4.65;p<0.001), NIMV要求(OR:2.31;95%置信区间:1.41—-5.13;P<0.001)是住院的独立预测因子。结论。我们的发现可能有助于在早期阶段确定需要住院治疗的患者。
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Predictors of hospitalization in patients presenting to emergency department with an acute exacerbation of COPD – a single-center study in Turkey
Introduction and aim. In this study, we evaluated parameters that might be associated with hospitalization in patients admitted to the emergency department (ED) with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material and methods. Patients with COPD who presented to ED due to AECOPD between January 1, 2020 and December 31, 2021 were included in the study. Patient data were obtained from the hospital database. Univariable and multivariable logistic regression methods were used to identify the relationship between hospitalization and clinical parameters. Results. The study included 237 patients divided into two groups: inpatients (n=124) and outpatients (n=113). We found significant differences between the two groups in terms of temperature, oxygen saturation, respiratory rate, C-reactive protein, white blood cell count, procalcitonin, albumin, arterial blood pH, pCO 2 , and non-invasive mechanical ventilation (NIMV) requirement. Multivariable logistic regression analysis showed that body temperature [odds ratio (OR):1.62;95% confidence interval (CI):1.21–4.91; p<0.001], oxygen saturation (OR:0.73, 95% CI:0.39-0.94, p<0.001), respiratory rate (OR:1.96; 95% CI: 1.07–6.14; p<0.001), albumin (OR:0.71; 95% CI:0.41–0.93; p=0.042), procalcitonin (OR:2.93; 95% CI:1.22–4.84; p<0.001), arterial blood pH (OR:0.78; 95% CI:0.29-0.91; p=0.038), pCO 2 (OR:2.45; 95% CI:1.24–4.65; p<0.001), and NIMV requirement (OR:2.31; 95% CI:1.41–5.13; p<0.001) were the independent predictors of hospitalization. Conclusion. Our findings may help identify patients who will require hospitalization at an early stage.
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