Exploration of risk factors for mortality in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease
Objective To investigate the risk factors for in-hospital mortality in patients with acute exacerbation of chronic obstruc-tive pulmonary disease(AECOPD).Methods The included subjects were divided into a death group(n=48)and a survival group(n=861)according to treatment outcomes in the Hefei First People's Hospital from January 2019 to December 2021.The independent risk factors of death during hospitalization were screened by logistics regression analysis,and a regression model was established.Receiver operating characteristic curve(ROC curve)was used to evaluate the predictive power of the regression model for in-hospital deaths.R was used to evaluate the relationship between patient age and in-hospital mortality.Results Age[odds ratio(OR)=1.20,95%confi-dence interval(CI):(1.09,1.31)],number of hospitalizations in the previous year[OR=1.49,95%CI:(1.12,1.96),arterial partial carbon dioxide pressure[OR=1.07,95%CI:(1.02,1.11)],home noninvasive ventilation[OR=5.92,95%CI:(1.37,25.58)],diabetes mellitus[OR=5.49,95%CI:(1.32,22.77),was an independent risk factor for in-hospital death in patients with AECOPD.The area under ROC curve of five independent risk factors predicting the risk of AECOPD inpatient death was 0.93,95%CI:(0.88,0.93),the critical value was 0.83,and the sensitivity and specificity were 0.88 and 0.52,respectively.The segmental regression model was used to analyze the threshold effect,which showed that the optimal turning point was 85 years old,and the mortality of patients after 85 years old increased with the increase of age[OR=2.5,95%CI:(1.40,4.30)].Conclusions Age,the number of hospitalizations in the previous year,home non-invasive ventilation,and diabetes were independent risk factors for the death of AECOPD patients during hospitalization.Early de-tection of those at risk of death in AECOPD patients and early implementation of targeted measures may reduce short-term hospital mor-tality.
万方数据
维普
