Clinical characteristics in patients with acute exacerbation of chronic obstructive pulmonary disease and different nutritional status and related factors of their prognosis

Abstract

Objective To explore the clinical characteristics in patients with acute exacerbation of chronic obstructive pulmonary disease and (AECOPD) altered nutritional status and to find the related factors of clinical remission rate of AECOPD within 1 year. Methods A total of 90 patients with AECOPD treated at our hospital from July to December, 2016 were collected and were divided into a low BMI group, a normal BMI group, and a high BMI group according to their BMI. The differences in general information and clinical indicators were compared between the three group. All the patients were followed up for 1 year after their discharge, and the influencing factors of clinical remission time were explored. Results The general data of the three groups showed that there was a statistical difference in smoking time between the normal BMI group and the high BMI group (P 0.05). The analysis of the 3 groups’ clinical characteristics suggested that there were no statistical differences in noninvasive ventilation ratio and low molecular weight heparin treatment between these groups (P>0.05), but were in plasma D-dimer, PaO2, PaCO2, forced expiratory volume in one second (FEV1), forced expiratory volume in one second / forced vital capacity (FEV1/FVC), and the hospitalization time (P<0.05). All of the patients were followed up for 1 year, and a total of 8 cases were lost; there were 3 cases in the low BMI group, 2 cases in the normal BMI group, and 3 cases in the high BMI group. The K-M analysis showed that there was a statistical difference in clinical remission within 1 year between the three groups (χ2=10.61, P<0.01). Single factor Cox regression model analysis showed that age, gender, smoking time, noninvasive ventilation, plasma D-dimer, PaO2, PaCO2, FEV1, FEV1/FVC, and low molecular weight heparin (LMWH) therapy affected the AECOPD patients in clinical remission time (P<0.05). Multivariate Cox regression model analysis showed that age, smoking time, plasma D- dimer, PaCO2, FEV1, and LMWH treatment were independent factors for AECOPD (P<0.05). Conclusions Different BMI status of AECOPD patients affect clinical indicators. Low BMI and high BMI are not conducive to the recovery of clinically relevant indicators; and age, smoking time, plasma D-dimer, PaCO2, FEV1, and LMWH treatment influence the patients’ clinical remission time. Key words: Acute exacerbation of chronic obstructive pulmonary disease; Prognosis; Kaplan-Meier analysis; Influencing factors