El marcador sistémico de inflamación PCR fue mejor factor pronóstico de rehospitalización por exacerbación aguda de la enfermedad pulmonar obstructiva crónica que los marcadores de inflamación del esputo

Abstract

IntroductionAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) readmission contributes considerably to the worse outcomes for COPD patients. Predictors for readmission include some socio-demographic variables and the severity of the underlying disease, however, few evidence suggested whether persistently heightened airway or systemic inflammation was related to recurrence of AECOPD. The aim of this study was to evaluate role of airway and systemic inflammatory biomarkers during AECOPD on predicting readmission for AECOPD. MethodsConsecutive hospitalized patients with AECOPD were recruited. Inflammatory and clinical indices were evaluated at the day of admission before starting therapy and the day of planned discharge (day 10-14). Predictors for readmission were assessed by binary logistic regression model. Results93 patients were included with 51 patients (54.8%) were readmitted due to AECOPD at least once during 1 year following the index admission. The logistic regression model indicated that age (OR=1.072, 95%CI: 1.012-1.135, P=.017), hs-CRP (high sensitive-C reactive protein) at day 14 (OR=1.392, 95%CI: 1.131-1.712, P=.002), CAT value at day 14 (OR=1.12, 95%CI: 1.031-1.217, P=.007) were the independent variables statistically significant in predicting rehospitalization. ConclusionSystemic inflammatory marker CRP was a better predictor of readmission than sputum inflammatory markers. CAT score and age were also useful to predict readmission.