The Summit Score Stratifies Mortality and Morbidity in Chronic Obstructive Pulmonary Disease
The Summit Score Stratifies Mortality and Morbidity in Chronic Obstructive Pulmonary Disease
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DOI：
10.2147/copd.s254437
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发表时间：
2020-01-01
影响因子：
2.8
通讯作者：
Blagev, Denitza P.
中科院分区：
文献类型：
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作者：
Horne, Benjamin D.;Hegewald, Matthew J.;Blagev, Denitza P.
简介：吸烟和其他心血管危险因素通常伴随慢性阻塞性肺疾病（COPD）。本研究推导并验证了Summit评分预测COPD和心血管风险患者死亡率的能力。方法：SUMMIT试验受试者（N= 16，485）年龄在40-80岁之间，COPD患者随机分为50%/50%推导组（N=8181）和内部验证组（N=8304）。Intermountain Healthcare的3项外部COPD确认包括有心血管风险的门诊患者（N=9251）、无心血管风险的门诊患者（N=8551）和住院患者（N= 26，170）。考克斯回归分析评估了40个全因死亡率的预测因子。包括联合糠酸氟替卡松（FF）100 μ g/维兰特罗25 μ g（VI）的SUMMIT治疗不包括在score.Results中：死亡率预测因子是FEV 1，心率，收缩压，体重指数，年龄，吸烟包年，以前的COPD住院，心肌梗死，心力衰竭，糖尿病，抗血栓形成，抗血小板，和黄嘌呤。结合Summit评分（推导：c=0.668），在SUMMIT验证中，四分位数4与1的HR=4.43（p
Introduction: Tobacco use and other cardiovascular risk factors often accompany chronic obstructive pulmonary disease (COPD). This study derived and validated the Summit Score to predict mortality in people with COPD and cardiovascular risks.Methods: SUMMIT trial subjects (N=16,485) ages 40-80 years with COPD were randomly assigned 50%/50% to derivation (N=8181) and internal validation (N=8304). Three external COPD validations from Intermountain Healthcare included outpatients with cardiovascular risks (N=9251), outpatients without cardiovascular risks (N=8551), and inpatients (N=26,170). Cox regression evaluated 40 predictors of all-cause mortality. SUMMIT treatments including combined fluticasone furoate (FF) 100 mu g/vilanterol 25 mu g (VI) were not included in the score.Results: Mortality predictors were FEV1, heart rate, systolic blood pressure, body mass index, age, smoking pack-years, prior COPD hospitalizations, myocardial infarction, heart failure, diabetes, anti-thrombotics, anti-arrhythmics, and xanthines. Combined in the Summit Score (derivation: c=0.668), quartile 4 vs 1 had HR=4.43 in SUMMIT validation (p