Nomograms for Predicting Coexisting Cardiovascular Disease and Prognosis in Chronic Obstructive Pulmonary Disease: A Study Based on NHANES Data

Abstract

Background. Chronic obstructive pulmonary disease (COPD) is a common chronic disease. Progression is further exacerbated by the coexistence of cardiovascular disease (CVD). We aim to construct a diagnostic nomogram for predicting the risk of coexisting CVD and a prognostic nomogram for predicting long-term survival in COPD. Methods. The 540 eligible participants selected from the NHANES 2005–2010 were included in this study. Logistic regression analysis was used to construct a diagnostic nomogram for the diagnosis of coexisting CVD in COPD. Cox regression analyses were used to construct a prognostic nomogram for COPD. A risk stratification system was developed based on the total score generated from the prognostic nomogram. We used C-index and ROC curves to evaluate the discriminant ability of the newly built nomograms. The models were also validated utilizing calibration curves. Survival curves were made using the Kaplan–Meier method and compared by the Log-rank test. Results. Logistic regression analysis showed that gender, age, neutrophil, RDW, LDH, and HbA1c were independent predictors of coexisting CVD and were included in the diagnostic model. Cox regression analysis indicated that CVD, gender, age, BMI, RDW, albumin, LDH, creatinine, and NLR were independent predictors of COPD prognosis and were incorporated into the prognostic model. The C-index and ROC curves revealed the good discrimination abilities of the models. And the calibration curves implied that the predicted values by the nomograms were in good agreement with the actual observed values. In addition, we found that coexisting with CVD had a worse prognosis compared to those without CVD, and the prognosis of the low-risk group was better than that of the high-risk group in COPD. Conclusions. The nomograms we developed can help clinicians and patients to identify COPD coexisting CVD early and predict the 5-year and 10-year survival rates of COPD patients, which has some clinical practical values.

The Emerging Clinical Significance of the Red Cell Distribution Width as a Biomarker in Chronic Obstructive Pulmonary Disease: A Systematic Review

“…Following the full-text review of the remaining 38 articles, one was further excluded because it did not fulfil the inclusion criteria (comment letter without providing new data), thus leaving 37 studies for final analysis ( Figure 1 ). Sixteen studies investigated patients with stable COPD [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], 20 investigated patients with AECOPD [ 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], and one investigated both groups [ 62 ]. Fourteen studies were conducted in China [ 32 , 33 , 35 , 36 , 38 , 40 , 41 , 48 , 51 , 53 , 56 , 57 , 58 , 61 ]; eleven in Turkey [ 26 , …”

“…Sixteen studies investigated patients with stable COPD [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], 20 investigated patients with AECOPD [ 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], and one investigated both groups [ 62 ]. Fourteen studies were conducted in China [ 32 , 33 , 35 , 36 , 38 , 40 , 41 , 48 , 51 , 53 , 56 , 57 , 58 , 61 ]; eleven in Turkey [ 26 , 27 , 28 , 29 , 30 ,…”

“…Fourteen studies were conducted in China [ 32 , 33 , 35 , 36 , 38 , 40 , 41 , 48 , 51 , 53 , 56 , 57 , 58 , 61 ]; eleven in Turkey [ 26 , 27 , 28 , 29 , 30 , 31 , 34 , 44 , 49 , 60 , 62 ]; two in Iran [ 42 , 47 ]; two in Israel [ 43 , 46 ]; and one in Indonesia [ 37 ], Croatia [ 39 ], Greece [ 50 ], India [ 45 ], Spain [ 52 ], Italy [ 54 ], Japan [ 55 ], and Belgium [ 59 ], respectively. Mean or median haemoglobin concentrations were reported as normal in 20 studies [ 26 , 27 , 28 , 30 , 31 , 32 , 34 , 35 , 36 , 40 , 41 , 42 , 44 , 47 , 49 , 54 , 59 , 60 ,…”

“…Since 2012, 17 studies (four prospective, twelve retrospective, and one with unclear information regarding design) have investigated the clinical role of the RDW in stable COPD [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 62 ]. Nine studies primarily investigated the relationship between the RDW and the presence and severity of COPD [ 26 , 28 , 29 , 30 , 31 , 34 , 36 , 37 , 39 , 62 ], four investigated the association with mortality [ 27 , 29 , 38 , 40 ], and the remaining five investigated associations with other parameters, i.e., pulmonary hypertension [ 30 , 32 , 41 ], pulmonary heart disease [ 33 ], and pulmonary embolism [ 35 ]. COPD was diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines in fourteen studies [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 41 ,…”

Prognostic value of neutrophils to lymphocytes and platelets ratio for 28-day mortality in patients with acute respiratory distress syndrome: a retrospective study

“…An elevated NLR value usually means an increase in neutrophils (reflecting a proinflammatory state) and/ or a decrease in lymphocytes (reflecting the weak adaptive immunity to diseases). Therefore, NLR has been suggested to predict the severity and mortality of various diseases, such as sepsis [7], community-acquired pneumonia [8,9], chronic obstructive pulmonary disease [10,11], acute limb ischemia [12], acute cholecystitis [13], cardiovascular disease [14][15][16], and intracerebral hemorrhage [17,18], as well as the recent pandemic COVID-19 pneumonia [14,[19][20][21].…”