在阻塞性呼吸道疾病中,死亡率和住院恶化的预测因素
Delphine Vauterin1,2, Frauke Van Vaerenbergh1,2, Maxim Grymonprez1,3
1Department of Bioanalysis, Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
ERJ open research
|September 10, 2025
概括
在比利时,虚弱,吸烟和过度使用短效支气管扩展剂 (SABD) 显著增加了喘和COPD患者的死亡率和住院恶化. 在初级保健中解决这些因素对于更好的患者结果至关重要.
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:
- 比利时的喘和COPD的年龄标准化住院率和死亡率高于欧洲平均水平.
- 优化患者管理需要更深入地了解导致住院恶化和死亡率的因素.
研究的目的:
- 确定比利时成年呼吸道阻塞性疾病患者全因死亡率和住院恶化的预测因素.
- 为改善患者护理和减少不良结果的策略提供信息.
主要方法:
- 一项基于索赔的全国性队列研究包括了18岁以上的患者,他们在2017年至2022年期间至少获得了两次阻塞性呼吸道疾病药物处方.
- 采用多变量Cox比例危险模型来分析死亡率和住院恶化的预测因素.
主要成果:
- 该研究分析了1,006,968名患者,其中3.9%的患者经历了住院恶化,14.4%的患者在随访期间死亡.
- 死亡率的显著预测因素包括虚弱 (aHR 2.09),严重的短效支气管扩展剂 (SABD) 过度使用 (aHR 1.81),目前的吸烟 (aHR 1.64) 和以前的门诊恶化 (aHR 1.52).
- 住院恶化的主要危险因素是最近住院恶化 (aHR 5.67),目前吸烟 (aHR 3.69),严重的SABD过度使用 (aHR 3.15) 和虚弱 (aHR 1.07).
结论:
- 以前的恶化,目前的吸烟,虚弱和SABD过度使用与喘/COPD患者的住院恶化和死亡率的增加密切相关.
- 这项研究强调了疾病控制,戒烟和初级保健机构脆弱管理的重要性.
- 结果提供了针对比利时呼吸系统患者的有针对性的干预措施以减轻风险和改善长期结果的证据.
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