Acute Phase Proteins as Predictors of Survival in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Mechanical Ventilation
Acute Phase Proteins as Predictors of Survival in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Mechanical Ventilation
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DOI：
10.1080/15412555.2019.1698019
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发表时间：
2019-12-07
影响因子：
2.2
通讯作者：
Madan, Karan
中科院分区：
文献类型：
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作者：
Sneh, Arora;Pawan, Tiwari;Madan, Karan
很少有研究试图评估需要机械通气（MV）的慢性阻塞性肺疾病（COPD）患者的预后变量。我们评估了需要MV的AE-COPD患者的血清C反应蛋白（CRP）、前白蛋白（PA）和转铁蛋白（TR）水平作为院内死亡率的预后标志物。对93例AE-COPD患者进行了MV评价。每天进行详细的临床评价。分别于入院时、第3、8、16天测定血清CRP、PA，于入院时、第8、16天测定TR。人口统计学、基线参数、CRP、PA和TR与死亡率相关。93例患者中，49例（52.69%）存活，44例（47.31%）死亡。APACHE Ⅱ、血清尿素和白蛋白在存活者和非存活者中相似。基线CRP（≥ 10.5 mg/dl）的敏感性为60.5%，特异性为60.2%，曲线下面积（AUC）为0.62作为死亡率的预测因子。第3天CRP（>= 7 mg/dl）的敏感性（65.5%）和特异性（63.3%）与AUC 0.70作为死亡率的预测因子。基线血清前白蛋白为11.00（0.09-29.26）mg/dl，幸存者和非幸存者相似（p = 0.7）。在第8天（n = 50）<13.5mg/dl的前白蛋白具有54.6%的灵敏度和51.4%的特异性，AUC 0.54（95%CI 0.34-0.75）作为死亡率的预测因子。第8天（n = 50）的转铁蛋白
Few studies have tried to assess prognostic variables in chronic obstructive pulmonary disease (COPD) patients requiring mechanical ventilation (MV). We evaluated serum C reactive protein, (CRP) pre-albumin (PA) and transferrin (TR) levels in AE-COPD patients requiring MV as prognostic markers of in hospital mortality. 93 AE-COPD patients on MV were evaluated. Detailed clinical evaluation was done daily. Serum CRP & PA were measured on admission, 3rd, 8th and 16th day; TR was measured on admission, 8th and 16th day. Demographics, baseline parameters, CRP, PA and TR were correlated with mortality. Of 93 patients, 49 (52.69%) survived whereas 44 patients (47.31%) died. APACHE II, serum urea & albumin were similar in survivors & non-survivors. Baseline CRP (>= 10.5 mg/dl) had sensitivity of 60.5%, specificity of 60.2%, with area under curve (AUC) of 0.62 as predictor of mortality. CRP (>= 7 mg/dl) on day 3 had sensitivity (65.5%) and specificity (63.3%) with AUC 0.70 as predictor of mortality. Baseline serum prealbumin was 11.00 (0.09-29.26) mg/dl, and similar in survivors & non-survivors (p = 0.7). Prealbumin at day 8 (n = 50) < 13.5 mg/dl had sensitivity 54.6%, and specificity 51.4% with AUC 0.54 (95% CI 0.34-0.75) as predictor of mortality. Transferrin at day 8 (n = 50) of