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Am J Med Sci. 2014 May;347(5):393-9. doi: 10.1097/MAJ.0b013e31829a63b1.

The value of assessment tests in patients with acute exacerbation of chronic obstructive pulmonary disease.

Author information

1
Department of Respiratory Medicine (Y-FZ), Pudong New Area Gongli Hospital, Shanghai, China; Department of Respiratory Medicine (Y-PJ), Hospital of The PLA, Wuxi, China; Department of Respiratory Medicine (L-FZ), The First Affiliated Hospital, Nanjing Medical University, Nanjing, China; and Department of Respiratory Medicine, Institute of Respiratory Medicine (X-LW), Xinqiao Hospital, Third Military Medical University, Chongqing, China.

Abstract

The aim of our study was to investigate the chronic obstructive pulmonary disease (COPD) assessment test (CAT), serum copeptin, procalcitonin and C-reactive protein (CRP) levels as potential predictive factors for recurrence of acute exacerbation and all-cause mortality in 6 months of COPD inpatients. One hundred fifty-nine patients who met the inclusion criteria were enrolled and followed up for 6 months. The CAT scores, serum copeptin, procalcitonin and CRP levels were measured on admission and 14 days and 3 months later in all patients. The primary endpoint was recurrence of acute exacerbation in 6 months. The secondary endpoint was all-cause mortality after 6 months. The CAT scores, serum copeptin, procalcitonin and CRP levels were significantly elevated on admission and stabilized at 14 days (P < 0.01). In a univariate logistic regression analysis, CAT scores (odds ratio [OR] = 1.10), forced expiratory volume in 1 second % (OR = 1.01), serum copeptin (OR = 1.32) and CRP levels (OR = 1.01) were significantly related to recurrence of acute exacerbation in 6 months (P < 0.05). In a multivariate logistic regression model, increasing CAT scores (OR = 1.10) and serum copeptin levels (OR = 1.29) were still associated with an increased odds of exacerbation (P < 0.05). In a univariate logistic regression analysis, increasing CAT scores (OR = 1.19), forced expiratory volume in 1 second % (OR = 1.05), serum copeptin levels (OR = 1.44) and hospitalization in the previous years (OR = 1.24) were significant determinants of death over a follow-up period of 6 months (P < 0.05). But only serum copeptin (OR = 1.53) and CAT scores (OR = 1.37) were associated with mortality in multivariate logistic regression analysis. Hence, high CAT scores and serum copeptin levels link with recurrence of acute exacerbation and all-cause mortality during 6 months in patients with acute exacerbation of COPD.

PMID:
24270077
DOI:
10.1097/MAJ.0b013e31829a63b1
[Indexed for MEDLINE]

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