Serum sIL-2R May Predict the Prognosis of Chronic Obstructive Pulmonary Disease Exacerbation

Abstract

Background: The exacerbation of chronic obstructive pulmonary disease (COPD) is a heterogeneous phenomenon associated with inflammation and clinical parameters. Knowing the predictors of poor prognosis in patients with COPD could help to provide adequate intensive therapy and closer follow-up. The aim of this study was to disclose the correlation between the serum soluble IL-2R (sIL-2R) and prognosis in COPD exacerbation. Methods: Two hundred and ninety-four patients with COPD exacerbation were recruited between December 2017 and December 2019. Patients underwent lung function (spirometry) assessment, demographic and clinical parameters were collected, and a metabolic profile and inflammatory profile were created. Adverse outcomes included the following: death during hospitalisation or 1-month follow-up, intensive care unit admission, invasive or non-invasive mechanical ventilation and COPD-related emergency visit or readmission within 1 month after discharge. Univariate and multivariate analyses were performed to identify factors related to adverse outcomes in COPD exacerbation. The receiver operating characteristic (ROC) curve was used to determine the optimal diagnostic threshold for the predictors. Results: We enrolled 294 patients, of whom 157 and 137 had good outcomes and adverse outcomes, respectively. We demonstrated that patients with poor outcomes in COPD exacerbation had a higher smoking index or concomitant congestive heart disease, and patients with hypercapnia were more likely to have a worse prognosis. An elevated level of sIL-2R at admission was an independent risk predictor for poor prognosis in COPD exacerbation with a cut-off value of 860 U/mL. Hypercapnia was the strongest predictor with a cut-off value of 54.25 mmHg. Conclusions: The presence of hypercapnia and elevated level of sIL-2R increased the risk of the adverse outcomes in COPD exacerbation. Keywords: chronic obstructive pulmonary disease, exacerbation, hypercapnia, soluble interleukin-2 receptor, predictive factor