Serum uric acid is increased in respiratory disease, especially in the presence of hypoxia and systemic inflammation. We evaluated serum uric acid as a biomarker for prediction of mortality and future acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Serum uric acid was measured in 314 eligible consecutive patients on admission for AECOPD. Patients were evaluated monthly for 1 year.Uric acid levels were higher in patients with more severe airflow limitation and in those experiencing frequent exacerbations. High uric acid levels (o6.9 mg?dL -1 ) were an independent predictor of 30-day mortality in multivariate Cox regression analysis (HR 1.317, 95% CI 1.011-1.736; p50.044), but not of 1-year mortality. Patients with high serum uric acid required more prolonged hospitalisation, and more often needed noninvasive ventilation and admission to the intensive care unit within 30 days. In addition, high uric acid levels were associated with increased risk and hospitalisation for AECOPD in 1 year in multivariate Poisson regression analysis (incidence rate ratio 1.184 (95% CI 1.125-1.246) and 1.190 (95% CI 1.105-1.282), respectively; both p,0.001).Serum uric acid is associated with increased 30-day mortality and risk for AECOPD and hospitalisations in 1-year follow-up. This low-cost biomarker may be useful in the identification of high-risk chronic obstructive pulmonary disease patients that could benefit from intensive management. @ERSpublications Serum uric acid was linked with airflow limitation in COPD and predicted mortality and future exacerbations
The NQ is a valid and reliable questionnaire for screening HVS in patients with stable mild-to-moderate asthma.
The impact of depressive symptoms on outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been thoroughly evaluated in prospective studies.We prospectively enrolled 230 consecutive patients hospitalised for AECOPD, without previous diagnosis of depression. Depressive symptoms were evaluated with Beck's depression inventory. Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and on days 3, 10 and 40. Patients were evaluated monthly for 1 year.Patients with depressive symptoms required longer hospitalisation (mean¡SD 11.6¡3.7 versus 5.6¡4.1 days, p,0.001). Clinical variables improved during the course of AECOPD, but depressive symptoms on admission had a significant impact on dyspnoea (p,0.001) and CAT score (p50.012) improvement. Patients with depressive symptoms presented more AECOPD (p,0.001) and more hospitalisations for AECOPD (p,0.001) in 1 year. In multivariate analysis, depressive symptoms were an independent predictor of mortality (hazard ratio 3.568, 95% CI 1.302-9.780) and risk for AECOPD (incidence rate ratio (IRR) 2.221, 95% CI 1.573-3.135) and AECOPD hospitalisations (IRR 3.589, 95% CI 2.319-5.556) in 1 year.The presence of depressive symptoms in patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalisations in 1 year.
Cardiovascular disease (CVD), diabetes mellitus and arterial hypertension increase the risk of death and hospitalisations of chronic obstructive pulmonary disease (COPD) patients [1]. COPD patients with CVD are at increased risk of COPD-related hospitalisations [2]. Arterial hypertension is one of the most prevalent comorbidities, influencing 40-60% of COPD patients [1]. Diabetes mellitus is more prevalent in moderate to very severe COPD than in the general population [1] and hyperglycaemia during acute exacerbations of COPD (AECOPD) is associated with increased in-hospital mortality [3]. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has proposed a multidimensional classification for COPD management [4,5] that includes symptoms and future risk of AECOPD, based on the severity of airflow limitation and previous exacerbation history. A recent study has shown that the risk of future hospital admission due to COPD and cardiovascular death is higher in the more symptomatic group B compared with group C, regardless the functional advantage of patients in the first group [6]. Our study assessed the effect of CVD, arterial hypertension and diabetes mellitus on the time to first AECOPD, and on exacerbation and hospitalisation risk in groups A-D of the GOLD 2011 and 2013 classification, in a cohort of patients admitted to hospital for AECOPD.We prospectively enrolled 609 consecutive patients admitted to respiratory medicine departments of two tertiary hospitals with a diagnosis of AECOPD between March 2009 and February 2013. All subjects were current or ex-smokers with ⩾20 pack-years and a previous spirometry-confirmed diagnosis of COPD. Patients with other comorbid respiratory conditions, comorbidities that might result in a limited expected survival (such as malignancies, leukaemia or AIDS) or with an inability to cooperate with the investigators were excluded. The study protocol was approved by the ethics committees of both hospitals and participants provided informed consent. Symptoms were evaluated according to the COPD assessment test (CAT) [7] and the modified Medical Research Council (mMRC) dyspnoea scale [8]. Spirometry data were from patients' medical records when their COPD was stable (during the last 6 months and ⩾4 weeks before admission). Patients were categorised into the GOLD 2011 groups, as follows. Group A: fewer symptoms (mMRC <2/CAT <10), forced expiratory volume in 1 s (FEV1) >50% predicted and fewer than two exacerbations in the previous year. Group B: more symptoms (mMRC ⩾2/CAT ⩾10), FEV1 >50% predicted and fewer than two exacerbations in the previous year. Group C: fewer symptoms (mMRC <2/ CAT <10), FEV1 ⩽50% predicted and/or two or more exacerbations in the previous year. Group D: more symptoms (mMRC ⩾2/CAT ⩾10), FEV1 ⩽50% predicted and/or two or more exacerbations in the previous year [4]. In cases of discrepancy between the CAT and mMRC scales, the patient was categorised in the higher category (B or D). We performed an additional analysis classifying all our hospitalised pat...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.