Value of body mass index and serum albumin in prognostic evaluation in acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective To investigate the value of body mass index (BMI) and serum albumin (ALB) in prognostic evaluation in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) . Methods The clinical data of 407 AECOPD patients, who stayed in the Department of Respiratory Medicine of our hospital and were examined for BMI and ALB between March 2013 and March 2016, were included in the study. According to the survival status at the time of hospital discharge, all patients were divided into the survival group and death group. The receiver-operator-curve (ROC) analysis was used to determine the cut-off value, sensitivity, and specificity of BMI and serum ALB in the survival patients. Univariate analysis and Logistic regression analysis were used to identify the risk factors for in-hospital mortality. Results Among the 407 patients, 384 survived and 23 died, and the mortality was 5.7%. The levels of ALB and BMI in the survival group were higher than those in the death group [ALB: (37.2±4.4) g/L vs (32.5±6.1) g/L, BMI: (21.2±3.8) kg/m2 vs (19.5±3.0) kg/m2, all P 7.14 mmol/l, ALB 50 mmHg were the risk factors of in-hospital mortality. Logistic regression analysis showed that ALB>34.2 g/L (OR=0.17, 95%CI: 0.06-0.45) and BMI>19.9 kg/m2 (OR=0.26, 95%CI: 0.09-0.73) were the protective factors of in-hospital mortality, whereas the comorbidity of chronic heart failure (OR=6.80, 95%CI: 2.54-18.25) and kidney dysfunction (OR=5.97, 95%CI: 1.94-18.35) were the risk factors of in-hospital mortality. Conclusion ALB>34.2 g/L and BMI>19.9 kg/m2 are the protective factors of in-hospital mortality in AECOPD patients. Key words: Pulmonary disease, chronic obstructive; Body mass index; Serum albumin; Prognosis