Development and validation of a prediction index for recent mortality in advanced COPD patients

Abstract

The primary barrier to initiating palliative care for advanced COPD patients is the unpredictable course of the disease. We enroll 752 COPD patients into the study and validate the prediction tools for 1-year mortality using the current guidelines for palliative care. We also develop a composite prediction index for 1-year mortality and validate it in another cohort of 342 patients. Using the current prognostic models for recent mortality in palliative care, the best area under the curve (AUC) for predicting mortality is 0.68. Using the Modified Medical Research Council dyspnea score and oxygen saturation to define the combined dyspnea and oxygenation (DO) index, we find that the AUC of the DO index is 0.84 for predicting mortality in the validated cohort. Predictions of 1-year mortality based on the current palliative care guideline for COPD patients are poor. The DO index exhibits better predictive ability than other models in the study.

Synergistic effects of COVID-19 and Pseudomonas aeruginosa in chronic obstructive pulmonary disease: a polymicrobial perspective

“…The SARS-CoV-2 virus enters the lungs in a sequential process involving the attachment of cellular components to the host individuals and forwarded by endocytosis, which is bridged by membrane bound spike-like viral protein particles with S1 receptor binding subunit and another protein called S2 membrane fusion subunit [ 5 , 17 ]. Interestingly, SARS-CoV-2 exploits the ACE-2 leading to communication as a receptor molecule for cellular compartment attachment.…”

“…COVID-19 symptoms are mild at initially, but lung function quickly and severely deteriorate due to lung alveolar rupture. The prodrome of early mild symptoms appears to be more problematic in COPD suspects [ 5 ]. As a result, a lack of awareness of the differences between illnesses may cause a delay in early diagnosis and treatment.…”