Serum magnesium is an independent predictor of frequent readmissions due to acute exacerbation of chronic obstructive pulmonary disease
Serum magnesium is an independent predictor of frequent readmissions due to acute exacerbation of chronic obstructive pulmonary disease
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DOI：
10.1016/j.rmed.2008.02.010
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发表时间：
2008-07-01
影响因子：
4.3
通讯作者：
Fioravanti, Gloria T.
中科院分区：
文献类型：
--
作者：
Bhatt, Surya Prakash;Khandelwal, Pooja;Fioravanti, Gloria T.
慢性阻塞性肺疾病（AECOPD）急性加重期再入院的预测因素尚未明确。确定可修改的预测因素可能有助于减少再入院的负担。本研究旨在评估血清镁在频繁再入院中的作用。方法：回顾性分析2004年4月~ 2006年3月在某三级医疗中心诊断为AECOPD的100例患者，从指数入院时间至下次入院或死亡。指数入院后一年的入院人数计算，再入院频次定义为每年>= 3次。排除其他呼吸系统疾病、肾功能衰竭和充血性心力衰竭患者。入院时用比色法测定血清镁。采用Logistic回归分析寻找再入院的独立危险因素。结果：患者平均年龄为71.9（±10.9标准差（SD））岁。57名女性。90%的人现在或曾经吸烟。到下次入院的中位时间为108天（范围2-842）。在随访的第一年，共有87例患者至少再入院一次，其中5%死亡；23%的人经常再入院；85%的儿童在5年内接种过肺炎球菌疫苗；29%的人在当前季节接种了流感疫苗。再入院的频率不受吸入或口服类固醇和出院时利尿剂的影响。疫苗接种并不能防止频繁的再入院。频繁再入院的唯一预测因子是血清镁水平（1.77 +/- 0.19 vs 1.86 +/- 0.24 mEq/L；校正优势比0.003,95%可信区间< 0.001-0.55;p = 0.03）。结论：低血镁水平独立预测AECOPD再入院。这是一个容易改变的风险因素。(c) 2008 Elsevier Ltd.版权所有。
Introduction: Predictors of readmission for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not well defined. Identifying modifiable predictors may help reduce the burden of readmissions. This study was done to evaluate the role of serum magnesium in frequent readmissions.Methods: One hundred patients admitted with a diagnosis of AECOPD to a tertiary care center from April 2004 to March 2006 were retrospectively followed from the time of index admission until the next admission or death. Number of admissions was calculated for the year after index admission, and frequent readmission was defined as >= 3 per year. Patients with other respiratory diseases, renal failure, and congestive heart failure were excluded. Serum magnesium was assayed at the time of admission by the colorimetric method. Logistic regression analysis was used to find independent risk factors for readmission.Results: The mean age of patients was 71.9 (+/- 10.9 standard deviation (SD)) years. Fifty-seven were females. Ninety percent were current or ex-smokers. The median duration of time to next admission was 108 days (range 2-842). A total of 87 patients were readmitted at least once during the first year of follow-up, white 5% died; 23% had frequent readmissions; 85% had received pneumococcal vaccine within 5 years; and 29% received influenza vaccine in the current season. Frequency of readmissions was not influenced by the administration of inhaled or oral steroids, and diuretics at the time of discharge. Vaccination did not protect against frequent readmissions. The sole predictor of frequent readmissions was serum magnesium level (1.77 +/- 0.19 vs. 1.86 +/- 0.24 mEq/L; adjusted odds ratio 0.003, 95% Confidence intervals < 0.001-0.55; p = 0.03).Conclusions: Lower serum magnesium level independently predicts readmission for AECOPD. This is an easily modifiable risk factor. (c) 2008 Elsevier Ltd. All rights reserved.