Predictors of duration of noninvasive ventilation in severe COPD exacerbation

Steriade, Alexandru Tudor; Johari, Shirin; Filip, Nicoleta; Tudose, Cornelia; Bogdan, Miron Alexandru; Bumbăcea, Dragoş

doi:10.1183/13993003.congress-2018.pa2350

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“…Regarding COPD prognosis, we showed that both low and high levels of HbA1c were associated with an increased risk of all‐cause death in COPD cases. Previous studies reported the association of HbA1c level with the exacerbation of COPD, which is a severe complication associated with increased short‐ and long‐term mortality 7,13,51 . A case‐control study reported that HbA1c in COPD patients was associated with exacerbation of COPD and was significantly higher compared with those that were stable, which indicated that HbA1c is a good predictor of disease severity in patients with COPD 7 .…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies reported the association of HbA1c level with the exacerbation of COPD, which is a severe complication associated with increased short-and long-term mortality. 7,13,51 A case-control study reported that HbA1c in COPD patients was associated with exacerbation of COPD and was significantly higher compared with those that were stable, which indicated that HbA1c is a good predictor of disease severity in patients with COPD. 7 A cohort study of 526 patients with COPD found that higher HbA1c levels were significantly associated with the risk of severe exacerbation in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

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Association between glycated haemoglobin and the risk of chronic obstructive pulmonary disease: A prospective cohort study in UK biobank

Li,

Wan,

Zhu

et al. 2023

Diabetes Obesity Metabolism

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AimsTo investigate the association between glycated haemoglobin (HbA1c) levels and chronic obstructive pulmonary disease (COPD) incidents in the general population, and the association between HbA1c levels and mortality in patients with COPD.Materials and MethodsWe investigated the association of HbA1c levels with COPD risk in the general population in the UK Biobank, using data from 420 065 participants. Survival analysis was conducted for 18 854 patients with COPD. We used restricted cubic spline analysis to assess the dose‐response relationship between HbA1c levels and COPD risk and survival. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsDuring a median follow‐up of 12.3 years, 11 556 COPD cases were recorded. HbA1c had a non‐linear relationship with COPD risk (p for non‐linearity < .05). Compared with the quintile 2 (32.2‐<34.3 mmol/mol), those with HbA1c levels above 38.7 mmol/mol (quintile 5) had a 22% (HR, 1.22, 95% CI: 1.15‐1.30) higher risk of COPD. Compared with the HbA1c decile 2 (30.5‐<32.2 mmol/mol), the HRs (95% CI) of COPD risk were 1.16 (1.03‐1.30) and 1.36 (1.24‐1.50) in the lowest HbA1c decile (<30.5 mmol/mol) and highest decile (≥41.0 mmol/mol), respectively. The increased COPD risk associated with HbA1c was more pronounced in younger, current smokers, passive smokers, and participants with a higher Townsend deprivation index (all p for interaction < .05). Among patients with COPD, 4569 COPD cases died (488 because of COPD) during a median follow‐up of 5.4 years. Regarding COPD survival, HbA1c had a non‐linear relationship with all‐cause death (p for non‐linearity < .05). Those with HbA1c quintile 5 (≥38.7 mmol/mol) had a 23% (HR, 1.23, 95% CI: 1.10‐1.37) higher risk of all‐cause death compared with the quintile 2 (32.2‐<34.3 mmol/mol). Compared with the HbA1c decile 4 (33.3‐<34.3 mmol/mol), those in the lowest HbA1c decile (<30.5 mmol/mol) and highest HbA1c decile (≥41.0 mmol/mol) had 22% (HR, 1.22; 95% CI: 1.01‐1.47) and 28% (HR, 1.28; 95% CI: 1.11‐1.48) higher risk for overall death. However, no significant association was observed between HbA1c levels and the risk of COPD‐specific death.ConclusionsOur findings indicated that lower and higher HbA1c levels were associated with a higher risk of COPD. In COPD cases, lower and higher HbA1c levels were associated with a higher COPD all‐cause death risk.

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Section: Discussionmentioning

confidence: 96%