Observational cohort study of outcomes in patients admitted to the intensive care unit for acute exacerbation of chronic obstructive pulmonary disease

Sivakumar, Sivanth; McNally, Angus; Tobin, Jonathan N.; Williamson, Jonathan; Åneman, Anders

doi:10.1111/imj.13805

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Moreover, lack of reliable biomarkers greatly limited in guiding clinicians in identifying patients for ICU admission. [24] Compared to the control group, patients with elevated IgE levels had a lower risk of mechanical ventilation and ICU admission. These data suggested that total serum IgE levels could be a useful biomarker to assess the severity of AECOPD and inform decisions for patients requiring mechanical ventilation treatment and ICU admission.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the total serum IgE levels in patients with acute exacerbations chronic obstructive pulmonary disease: A retrospective study

Xie,

Zheng,

et al. 2024

Medicine

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Currently, few studies have demonstrated the relationship between total serum IgE (T-IgE) and acute exacerbation chronic obstructive pulmonary disease (AECOPD). In this study, T-IgE in AECOPD patients were investigated and jointly analyzed with the clinical characteristics. AECOPD patients hospitalized from July 2018 to July 2019 were included in this study. In this patient cohort, clinical information was investigated. Routine blood tests, C-reactive protein and T-IgE levels of patients were determined along with blood gas analysis. The length of hospital stays, mechanical ventilation during hospitalization, ICU admission, glucocorticoid related clinical information were recorded. A total of 285 AECOPD patients were included in this study, which consisted of a high proportion of males. Of all patients, 49.82% patients exhibited higher T-IgE levels. Based on the reference T-IgE value 60 kU/L, patients were divided into high T-IgE group with T-IgE > 60 kU/L, and low T-IgE group with T-IgE ≤ 60 kU/L. There was no significant difference in the dosage of glucocorticoid between the two groups. Patients in the high T-IgE group had shorter hospital stays and lower probability of mechanical ventilation compared to the low T-IgE group. After adjustment for confounding factors, T-IgE was negatively correlated with the length of hospital stays. AECOPD patients with elevated T-IgE had shorter hospital stays and lower risks of mechanical ventilation and ICU admission. Our results showed that T-IgE might play an important role on evaluating the condition and guiding for treatment decisions in AECOPD patients.

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Section: Discussionmentioning

confidence: 99%

Analysis of the total serum IgE levels in patients with acute exacerbations chronic obstructive pulmonary disease: A retrospective study

Xie,

Zheng,

et al. 2024

Medicine

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“…The selection of features and the time span of observation are also very important, and there are many factors that influence the prognosis of patients with AECOPD. Multiple studies have attempted to predict risk factors that affect mortality and readmission rates in AECOPD patients, such as acute physiology and chronic health evaluation scores, C-reactive protein, blood carbon dioxide partial pressure, and blood urea nitrogen [26,27]. Obviously, incorporating more features and increasing observation time is beneficial to improve the accuracy of the forecast, but it also increases the cost and complexity of the assessment.…”

Section: Discussionmentioning

confidence: 99%

Fast Prediction of Deterioration and Death Risk in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Using Vital Signs and Admission History: Retrospective Cohort Study

et al. 2019

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BackgroundChronic obstructive pulmonary disease (COPD) has 2 courses with different options for medical treatment: the acute exacerbation phase and the stable phase. Stable patients can use the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to guide treatment strategies. However, GOLD could not classify and guide the treatment of acute exacerbation as acute exacerbation of COPD (AECOPD) is a complex process.ObjectiveThis paper aimed to propose a fast severity assessment and risk prediction approach in order to strengthen monitoring and medical interventions in advance.MethodsThe proposed method uses a classification and regression tree (CART) and had been validated using the AECOPD inpatient’s medical history and first measured vital signs at admission that can be collected within minutes. We identified 552 inpatients with AECOPD from February 2011 to June 2018 retrospectively and used the classifier to predict the outcome and prognosis of this hospitalization.ResultsThe overall accuracy of the proposed CART classifier was 76.2% (83/109 participants) with 95% CI 0.67-0.84. The precision, recall, and F-measure for the mild AECOPD were 76% (50/65 participants), 82% (50/61 participants), and 0.79, respectively, and those with severe AECOPD were 75% (33/44 participants), 68% (33/48 participants), and 0.72, respectively.ConclusionsThis fast prediction CART classifier for early exacerbation detection could trigger the initiation of timely treatment, thereby potentially reducing exacerbation severity and recovery time and improving the patients’ health.

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Differences between COPD patients and their families regarding willingness toward life-sustaining treatments

Chen

Chiu

et al. 2019

Journal of the Formosan Medical Association

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Observational cohort study of outcomes in patients admitted to the intensive care unit for acute exacerbation of chronic obstructive pulmonary disease

Abstract: In patients admitted to ICU for AECOPD, limitations of medical therapy are frequent and associated with significant mortality. Involving palliative care in addition to respiratory physicians and intensivists in the management of AECOPD patients admitted to ICU needs to be explored further.

Cited by 4 publications

References 31 publications

Analysis of the total serum IgE levels in patients with acute exacerbations chronic obstructive pulmonary disease: A retrospective study

Analysis of the total serum IgE levels in patients with acute exacerbations chronic obstructive pulmonary disease: A retrospective study

Fast Prediction of Deterioration and Death Risk in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Using Vital Signs and Admission History: Retrospective Cohort Study

Differences between COPD patients and their families regarding willingness toward life-sustaining treatments

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