Background
Methods
Study design and inclusion and exclusion criteria
Definitions
Severity scoring
Data collection
Statistical analysis
Results
Patient characteristics
Covariates | nCOPD-CAP | COPD-CAP | P Valuea |
---|---|---|---|
Subjects, n | 290 | 230 | |
Males | 117(40.3) | 170(73.9) |
< 0.001
|
Age, years | 79[67,86] | 82[74,87] |
0.003
|
Ex-smoker or current smoking | 86(29.7) | 162(70.4) |
< 0.001
|
Comorbidities | |||
Diabetes | 50(17.2) | 47(20.4) | 0.353 |
Coronary heart disease | 74(25.5) | 93(40.4) |
< 0.001
|
Hypertension | 145(50) | 98(42.6) | 0.093 |
Cerebral infarction | 50(17.2) | 10(4.3) |
< 0.001
|
Symptom | |||
Cough | 288(99.3) | 209(90.9) |
< 0.001
|
Fever ≥38 °C | 154(53.1) | 79(34.3) |
< 0.001
|
Dyspnea | 52(17.9) | 205(89.1) |
< 0.001
|
Expectoration | 287(99) | 226(98.3) | 0.705 |
Mucoid | 66(22.8) | 90(39.1) |
< 0.001
|
Purulent | 211(73.5) | 129(57.1) | |
Haemoptysis | 10(3.4) | 7(3) | |
Pleural pain | 24(8.3) | 13(5.7) | 0.304 |
Altered mental state | 17(5.9) | 9(3.9) | 0.418 |
Respiratory frequency > 30 breaths · min−1 | 11(3.8) | 21(9.1) |
0.016
|
Laboratory results | |||
Hemoglobin, g/L | 120[108,130.25] | 124[113.75,135] |
0.001
|
Hematocrit, % | 36.15[32.78,39] | 37.7[34.5,41] |
< 0.001
|
WBC count > 10 × 109 cell | 84(29.0) | 79(34.3) | 0.189 |
C-reactive protein, mg/L | 24.25[5.08,70.57] | 32.67[7.99,72.55] | 0.267 |
Arterial PH < 7.35 | 12(4.1) | 58(25.2) |
< 0.001
|
PaO2 < 60 mmHg | 44(15.2) | 81(35.2) |
< 0.001
|
PaCO2 > 50 mmHg | 16(5.5) | 74(32.2) |
< 0.001
|
Albumin, g/L | 34.35[31.2,37.35] | 34.1[31.28,37.3] | 0.728 |
Pre-albumin, mg/L | 146.779 ± 65.414 | 145.974 ± 65.850 | 0.889 |
D-dimer > 2.0 μg/mL | 62(21.4) | 45(19.6) | 0.611 |
Spirometry | |||
FEV1% predicted | ≥70 | 45.01 ± 15.76 | |
GOLD 1b | 9(3.9) | ||
GOLD 2 | 80(34.8) | ||
GOLD 3 | 88(38.3) | ||
GOLD 4 | 53(23) | ||
Aspiration | 53(18.3) | 29(12.6) | 0.078 |
Need for ICU admission | 38(13.1) | 42(18.3) | 0.105 |
Need for NIMV | 4(1.4) | 60(26.1) |
< 0.001
|
Outcome measures | |||
Length of hospital stay, d | 14[12,19] | 16[13.88,20.63] |
< 0.001
|
In-hospital mortality | 19(6.6) | 19(8.3) | 0.457 |
60-day mortality | 26(9) | 29(12.6) | 0.180 |
Comparison of different primary outcomes of predictive rules
Risk groups | No of patients (N = 520) | In-hospital mortality (N = 38) | 60-day mortality (N = 55) | ||||||
---|---|---|---|---|---|---|---|---|---|
nCOPD-CAP | COPD-CAP | P valuea | nCOPD-CAP | COPD-CAP | P valuea | nCOPD-CAP | COPD-CAP |
P value
a
| |
PSI | 79[64.75,101.25] | 95[77.128.25] |
< 0.001
| 169.26 ± 31.52 | 170.37 ± 46.21 | 0.932 | 160.42 ± 32.1 | 164.93 ± 41.11 | 0.655 |
Mild | 184(63.4) | 106(46.1) |
< 0.001
| 0(0) | 1(5.3) | 0.171 | 0(0) | 1(3.4) | 0.907 |
Moderate | 77(26.6) | 68(29.6) | 2(10.5) | 4(21) | 5(19.2) | 6(20.7) | |||
Severe | 29(10) | 56(24.3) | 17(89.5) | 14(73.7) | 21(90.8) | 22(75.9) | |||
CURB-65 | 1[1,2] | 1[1,2] |
< 0.001
| 3.47 ± 0.84 | 3.37 ± 1.21 | 0.758 | 3.12 ± 0.99 | 3.10 ± 1.08 | 0.966 |
Mild | 214(73.8) | 120(52.2) |
< 0.001
| 0(0) | 2(10.5) | 0.2 | 1(3.8) | 2(6.9) | 0.929 |
Moderate | 53(18.3) | 78(33.9) | 1(5.3) | 2(10.5) | 5(19.2) | 6(20.7) | |||
Severe | 23(7.9) | 32(13.9) | 18(94.7) | 15(79) | 20(76.9) | 21(72.4) | |||
APACHE-II | 8[6,12] | 13[9.75,17] |
< 0.001
| 28[26,32] | 25[15,33] | 0.253 | 26.62 ± 5.14 | 24.38 ± 8.12 | 0.234 |
Mild | 182(62.8) | 57(24.8) |
< 0.001
| 0(0) | 0(0) |
< 0.001
| 0(0) | 0(0) |
< 0.001
|
Moderate | 77(26.5) | 134(58.2) | 0(0) | 6(31.6) | 1(3.8) | 9(31) | |||
Severe | 31(10.7) | 39(17) | 19(100) | 13(68.4) | 25(96.2) | 20(69) |
Mortality risk factors
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
OR (95%CI) | P valuea | OR (95%CI) | P valuea | |
Age ≥ 70 | 4.211(0.546,32.475) | 0.168 | ||
Ex-smoker or current smoking | 0.546(0.209,1.425) | 0.216 | ||
Coronary heart disease | 2.751(1.040,7.276) |
0.041
| ||
Cerebral infarction | 2.985(0.587,15.185) | 0.188 | ||
Aspiration | 19.563(6.806,56.228) |
< 0.001
| 5.203(1.443,18.757) |
0.012
|
Need for NIMV | 1.140(0.359,3.620) | 0.824 | ||
Albumin< 30 g/dl | 4.855(1.833,12.859) |
0.001
| ||
D-dimer> 2.0 μg/mL | 9.247(3.390,25.222) |
< 0.001
| 5.026(1.395,18.108) |
0.014
|
Arterial PH < 7.35 | 3.634(1.396,9.461) |
0.008
| ||
PaCO2 > 50 mmHg | 2.552(0.990,6.580) | 0.053 | ||
PSI > 130 | 11.267(3.843,33.030) |
< 0.001
| ||
CURB-65 ≥ 3 | 42.794(12.771,143.399) |
< 0.001
| 23.299(6.246,86.903) |
< 0.001
|
APACHE-II ≥ 20 | 15.417(5.390,44.092) |
< 0.001
|
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
OR (95%CI) | P valuea | OR (95%CI) | P valuea | |
Age ≥ 70 | 6.957(0.919,52.676) | 0.060 | ||
Ex-smoker or current smoking | 0.648(0.288,1.457) | 0.294 | ||
Coronary heart disease | 3.896(1.686,9.004) |
< 0.001
| 5.206(1.531,17.703) |
0.008
|
Cerebral infarction | 1.787(0.360,8.860) | 0.477 | ||
Aspiration | 14.311(5.769,35.501) |
< 0.001
| 7.921(2.256,27.816) |
0.001
|
Need for NIMV | 6.195(2.719,14.116) |
< 0.001
| 3.974(1.245,12.688) |
0.020
|
Albumin< 30 g/dl | 4.024(1.746,9.270) |
< 0.001
| ||
D-dimer> 2.0 μg/mL | 5.118(2.248,11.654) |
< 0.001
| ||
Arterial PH < 7.35 | 5.325(2.355,12.025) |
< 0.001
| ||
PaCO2 > 50 mmHg | 4.237(1.883,9.534) |
< 0.001
| ||
PSI > 130 | 15.437(6.109,39.009) |
< 0.001
| ||
CURB-65 ≥ 3 | 45.341(16.413,125.255) |
< 0.001
| 18.002(5.867,55.237) |
< 0.001
|
APACHE-II ≥ 20 | 21.287(8.503,53.292) |
< 0.001
|