Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Cardiovascular Links

Laratta, Cheryl R.; Eeden, Stephan Van

doi:10.1155/2014/528789

Cited by 47 publications

(43 citation statements)

References 192 publications

(272 reference statements)

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“…Increasing evidence supports the presence of a systemic inflammatory component, which is thought to provide the link between COPD and other extrapulmonary comorbidities 63,64. These include cardiovascular disorders, skeletal muscle dysfunction, diabetes, osteoporosis, anxiety, and depression 65–68.…”

Section: Methodsmentioning

confidence: 99%

The recent advances of phenotypes in acute exacerbations of COPD

Zhou

Zhao

et al. 2017

COPD

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Exacerbations of COPD are clinically relevant events with therapeutic and prognostic implications. Yet, significant heterogeneity of clinical presentation and disease progression exists within acute exacerbations of COPD (AECOPD). Currently, different phenotypes have been widely used to describe the characteristics among patients with AECOPD. This has proved to be significant in the treatment and prediction of the outcomes of the disease. In this review of published literature, the phenotypes of AECOPD were classified according to etiology, inflammatory biomarkers, clinical manifestation, comorbidity, the frequency of exacerbations, and so on. This review concentrates on advancements in the use of phenotypes of AECOPD.

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Section: Methodsmentioning

confidence: 99%

The recent advances of phenotypes in acute exacerbations of COPD

Zhou

Zhao

et al. 2017

COPD

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“…Factors predicting unplanned readmissions were taken from a literature search, and encompassed demographic, pharmacy, and medical variables. 19 , 22 – 30 They were then separated into the time period affected – at baseline or during the index hospitalization. Baseline characteristics were identified up to 12 months before index hospitalizations.…”

Section: Methodsmentioning

confidence: 99%

Assessing the importance of predictors in unplanned hospital readmissions for chronic obstructive pulmonary disease

Zhou²,

Suh

et al. 2015

CEOR

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PurposeThe all-cause readmission rate within 30 days of index admissions for chronic obstructive pulmonary disease (COPD) was approximately 21% in the United States in 2008. This study aimed to examine patient and clinical characteristics predicting 30-day unplanned readmissions for an initial COPD hospitalization and to determine those predictors’ importance.Patients and methodsA retrospective study was conducted in patients with COPD-related hospitalizations using commercial claims data from 2010 to 2012. The primary outcome was all-cause unplanned readmission, with secondary outcomes being COPD as primary diagnosis and COPD as any diagnosis unplanned readmissions. Factors predicting unplanned readmissions encompassed demographic, pharmacy, and medical variables identified at baseline and during the index hospitalization. Dominance analysis was conducted to rank the predictors in terms of importance, defined as the contribution to change in model fit of a predictor by itself and in combination with other predictors.ResultsAfter applying the inclusion and exclusion criteria, 18,282 patients with index COPD-related admissions were identified. Among them, the rates of unplanned readmissions with COPD as primary diagnosis, COPD as any diagnosis, and all-cause were 2.6%, 5.6%, and 7.3%, respectively. For each outcome, the readmission group was slightly older, had a greater COPD severity score, and required a longer length of stay. Moreover, the readmission group had larger proportions of patients with comorbidities, dyspnea/shortness of breath, intensive care unit stay, or ventilator use, compared to the non-readmission group. Dominance analysis revealed that the three most important predictors – heart failure/heart disease, anemia, and COPD severity score – accounted for 56% of the predicted variance in all-cause unplanned readmissions.ConclusionOverall, COPD severity score and heart failure/heart disease emerged as important factors in predicting 30-day unplanned readmissions across all three outcomes. Results from dominance analysis suggest looking beyond COPD-specific complications and focusing on comorbid conditions highly associated with COPD in order to lower all-cause unplanned readmissions.

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“…29,30 In addition, COPD as a cause of mortality tends to be undercoded in death certificates. 30 Our secondary outcomes were (1) separate components of the composite outcome, (2) hospitalizations due to respiratory diseases (COPD, asthma, pneumonia and influenza, and acute bronchitis or bronchitis not specified as acute or chronic), (3) hospitalizations due to CV disease (chronic heart failure, myocardial infarction, stroke), 31 and (4) hospitalization or emergency department visits due to any cause.…”

Section: Discussionmentioning

confidence: 99%