D-dimer/Fibrinogen ratio and recurrent exacerbations might have a potential impact to predict 90-day mortality in patients with COPD exacerbation

Abstract

BackgroundAccording to the World Health Organisation reports (WHO), COPD is the third leading cause of overall in the World by 2020. AimWe aimed to determine the prognostic predictors of 90-day mortality after an initial exacerbation in patients with acute exacerbation of COPD (AECOPD). Results Increased Charlson Comorbidity Score(CCS) (HR:1.47; p<0.05), readmission after initial exacerbation (HR:1.47; p<0.05) were predictive risk factors for 30-day mortality in multivariable regression model. The 90-day mortality rate was %11.8. Hypertension, increased median age, nutrition risk score (NRS), CCS, CAT score, and mMRC 4th level were possible risk factors for 90-day mortality. There was a significant difference in the mortality of patients with D-dimer/Fibrinogen ratios>0.11 and ≤0.11 (HR:2.47; p<0.05). Recurrent exacerbations after discharge were predictive risk factors for 90-day mortality in the multivariable regression model (HR:2.25; p<0.001) with the increased mortality risk 4.73 times (HR:4.73; p=0.002). Furthermore, a 1-unit increment of acute exacerbation increased the mortality risk 3.39 times (HR:3.39; p<0.001). ConclusionOur study showed that D-dimer/Fibrinogen ratio but not D-dimer and recurrent exacerbations after discharge might have a critical impact on 90-day mortality

Fibrin degradation products and survival in patients with chronic obstructive pulmonary disease: a protocolized prospective observational study

“…Further, differences in the multivariable models or a difference in the population of COPD patients could contribute. In acute exacerbations of COPD, the results are conflicting, with two studies finding a significant association between D-dimer and long-term mortality, where a third found no association [ 20 – 22 ].…”

“…In patients admitted with acute exacerbation of COPD, two studies showed that D-dimer predicted both in-hospital and one-year mortality [ 20 , 21 ], whereas another study failed to show any association between D-dimer and 90-days mortality [ 22 ].…”

Correlation of Serum Clara Cell Secretory Protein 16, Plasma Fibrinogen and Serum Amyloid A with the Severity of Acute Exacerbated COPD and Their Combination in Prognosis Assessment

“…Studies suggested that AECOPD patients had a high FIB level at the time of discharge implicating that the patient is still in a state of hypoxia and thus has a higher likelihood of respiratory failure and readmission. 14 …”

“…Studies suggested that AECOPD patients had a high FIB level at the time of discharge implicating that the patient is still in a state of hypoxia and thus has a higher likelihood of respiratory failure and readmission. 14 Another biomarker focused in our study is Clara cell secretory protein-16 (CC16), a major functional protein secreted by Clara cells. 15 In COPD, inflammation, oxidative stress and increased alveolar-capillary permeability significantly enhance the expression of CC16.…”