Frailty increases the risk of in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease: a real-world study_Chinese Journal of Evidence-Based Medicine

Authors：

LI Li ¹ , WANG Lei ² , ZHANG Li ² , ZHAO Chongyang ¹ , WANG Qin ¹ , LIU Ying ² , LIU Lei ² , YUAN Lishan ² , FENG Min ² , WANG Gang ² ,  KANG Deying ^1,3 ,  ZHANG Xin ²

1. Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

KANG Deying, Email: deyingkang@126.com; ZHANG Xin, Email: zhangxinwch@126.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; Frailty; In-hospital mortality; C-reactive protein; Albumin; Real-world study

DOI：

10.7507/1672-2531.202403072

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Objective To explore the association between frailty and in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Elderly patients who were hospitalized with AECOPD from June 2022 to December 2022 at a large tertiary hospital were selected. The independent prognostic factors including frailty status were determined by multivariate logistic regression analysis. Mediation effect analysis was used to evaluate the mediating relationships between C-reactive protein (CRP) and albumin and in-hospital death. Results The training set included 1 356 patients (aged 86.7±6.6), 25.0% of whom were diagnosed with frailty. The multiple logistic regression analysis showed that frailty, mean arterial pressure, Charlson comorbidity index, neutrophil–lymphocyte ratio, interleukin-6, CRP, albumin, and troponin T were associated with in-hospital mortality. Furthermore, CRP and albumin mediated the associations between frailty and in-hospital mortality. Conclusion Frailty may be an adverse prognostic factor for older patients admitted with an AECOPD. CRP and albumin may be parts of mechanism between frailty and in-hospital death.

Citation： LI Li, WANG Lei, ZHANG Li, ZHAO Chongyang, WANG Qin, LIU Ying, LIU Lei, YUAN Lishan, FENG Min, WANG Gang, KANG Deying, ZHANG Xin. Frailty increases the risk of in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease: a real-world study. Chinese Journal of Evidence-Based Medicine, 2024, 24(6): 652-657. doi: 10.7507/1672-2531.202403072 Copy

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3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.	Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2023.
17.	Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2024.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.	Shin B, Kim SH, Yong SJ, et al. Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia. Chron Respir Dis, 2019, 16: 1479972318809480.
41.
42.
43.

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2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2023.
17. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2024.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40. Shin B, Kim SH, Yong SJ, et al. Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia. Chron Respir Dis, 2019, 16: 1479972318809480.
41.
42.
43.

Chinese Journal of Evidence-Based Medicine

Frailty increases the risk of in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease: a real-world study

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