治疗强度水平作为慢性阻塞性肺病严重程度的代理:风险分层工具
Marie Dam Lauridsen1, Simon Grøntved2, Emil Fosbøl3
1Department of Respiratory Diseases, Respiratory Research Aalborg, Aalborg University Hospital, Aalborg, Denmark; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
在慢性阻塞性肺病 (COPD) 中,较高的治疗强度水平与增加的死亡率和住院风险相关. 在研究中,治疗强度水平 (TIL) 作为COPD严重程度的代理.
科学领域:
- 肺部医学 肺部医学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性阻塞性肺病 (COPD) 的严重程度与不良健康结果有关.
- 卫生登记册数据可用于评估治疗影响.
- 治疗强度水平 (TIL) 提供了对COPD严重程度的潜在代理.
研究的目的:
- 评估COPD治疗强度水平 (TIL) 与患者长期治疗结果之间的关联.
- 确定TIL是否可以作为潜在的COPD严重程度的可靠指标.
主要方法:
- 利用丹麦全国性的登记册,识别了2001-2016年间诊断的53,803名COPD患者.
- 将患者分为两层,从最小到最严重的TIL类别 (不使用,短期,单一,双重,三重疗法,口服皮质类固醇,长期氧气治疗).
- 根据TIL,使用生存分析来评估基于TIL的5年结果.
主要成果:
- 三种最严重的TIL显示所有原因死亡率显著增加 (三重治疗的aHR: 1.44,OCS: 1.67,LTOT: 2.91).
- 对于5年死亡率或COPD相关住院的综合结果 (三重治疗的aHR为2.30,OCS为2.85,LTOT为4.00) 观察到类似的模式.
- 较高的TIL始终与更大的风险有关.
结论:
- 增加TIL与五年死亡率升高和COPD相关的住院风险相关.
- 在流行病学研究中,TIL证明了作为COPD严重程度的代理的实用性.
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