抽象的
这项研究的目的是评估合并症在严重慢性阻塞性肺疾病(COPD)中的预后作用。在研究急性加重后,由270名COPD患者组成,平均(+/- SD)67岁+/- 9岁,从大学医院连续出院。一秒钟(FEV1)强制呼气量的平均值(+/- SD)为预测的34 +/- 16%,FEV1/强制生命力(FVC)为40.5 +/- 13.8%。最常见的合并症是:高血压(28%),糖尿病(14%)和缺血性心脏病(10%)。从临床记录中收集出院时临床,心电图(ECG)和呼吸功能数据。查尔森的指数用于量化合并症。随访是通过电话进行的。多元生存分析用于识别死亡的独立预测指标。队列的中位生存期为3.1岁。死亡由以下变量预测:年龄(HR)1.04; 95%置信区间(95%CI)1.02-1.05),ECG右心肥大的迹象(HR 1.76; 95%CI 1.30-2.38),慢性 renal failure (HR 1.79; 95% CI 1.05-3.02), ECG signs of myocardial infarction or ischaemia (HR 1.42; 95% CI 1.02-1.96), FEV1 < 590 mL (HR 1.49; 95% CI 0.97-2.27). A score based upon these variables predicted mortality at 5 yrs with a sensitivity of 63% and a specificity of 77%. Selected co-morbid diseases and electrocardiogram signs of right ventricular hypertrophy play a major prognostic role in advanced chronic obstructive pulmonary disease. The clinical assessment of patients with chronic obstructive pulmonary disease should include these important and easily measurable variables.