目的:在本研究中,我们旨在研究慢性阻塞性肺疾病(COPD)急性加重的急诊(ED)患者的当前预后评分与综合肺指数(IPI)之间的相关性,以及将IPI与其他评分结合使用在确定可以安全出院的患者中的诊断价值。
方法:这项研究是在2021年8月至2022年6月之间作为多中心和前瞻性观察研究进行的。在ED被诊断为COPD恶化(eCOPD)的患者被纳入研究,并根据全球慢性阻塞性肺疾病倡议(GOLD)分类进行分组。CURB-65(混乱,尿素,呼吸频率,血压,年龄超过65岁),BAP-65(血尿素氮,精神状态改变,脉搏率,年龄超过65岁),和DECAF(呼吸困难,嗜酸性粒细胞减少症,合并,学术界,记录患者的房颤)评分和IPI值。检查IPI与其他评分之间的相关性及其在检测轻度eCOPD中的诊断价值。CURB-IPI的诊断价值,由CURB-65和IPI的组合创建的新分数,在轻度eCOPD中进行了检查。
结果:该研究对110名患者(49名女性和61名男性)进行,平均年龄67(最小/最大:40/97)。IPI和CURB-65在检测轻度加重方面比DECAF和BAP-65评分具有更好的预测价值[曲线下面积(AUC)分别为0.893、0.795、0.735、0.541]。CURB-IPI得分,另一方面,对检测轻度加重具有最佳预测价值(AUC0.909)。
结论:我们发现IPI对轻度COPD急性加重的检测具有良好的预测价值,与CURB-65联合使用时,其预测值增加。我们认为CURB-IPI评分可以作为判断COPD加重患者是否可以出院的指南。
In this study, we aimed to examine the correlation between current prognostic scores and the integrated pulmonary index (IPI) in patients admitted to the emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD), and the diagnostic value of using the IPI in combination with other scores in determining patients who can be discharged safely.
This study was conducted as a multicenter and prospective observational study between August 2021 and June 2022. Patients diagnosed with COPD exacerbation (eCOPD) at the ED were included in the study and they were grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. The CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, and age older than 65 years), BAP-65 (Blood urea nitrogen, Altered mental status, Pulse rate, and age older than 65 years), and DECAF (Dyspnea, Eosinopenia, Consolidation, Academia, and atrial Fibrillation) scores and IPI values of the patients were recorded. The correlation between the IPI and the other scores and its diagnostic value in detecting mild eCOPD were examined. The diagnostic value of CURB-IPI, a new score created by the combination of CURB-65 and IPI, in mild eCOPD was examined.
The study was carried out with 110 patients (49 female and 61 male), mean age of 67 (min/max: 40/97). The IPI and CURB-65 had better predictive value in detecting mild exacerbations than DECAF and BAP-65 scores [Area under curves (AUC) were 0.893, 0.795, 0.735, 0.541 respectively]. The CURB-IPI score, on the other hand, had the best predictive value for detecting mild exacerbations (AUC 0.909).
We found that the IPI has good predictive value in the detection of mild COPD exacerbations, and its predictive value increases when used in combination with CURB-65. We think that the CURB-IPI score can be a guide when deciding whether patients with exacerbation of COPD can be discharged.