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首页> 外文期刊>Journal of Thoracic Disease >Clinical significance of Charlson comorbidity index as a prognostic parameter for patients with acute or subacute idiopathic interstitial pneumonias and acute exacerbation of collagen vascular diseases-related interstitial pneumonia
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Clinical significance of Charlson comorbidity index as a prognostic parameter for patients with acute or subacute idiopathic interstitial pneumonias and acute exacerbation of collagen vascular diseases-related interstitial pneumonia

机译：Charlson合并症指数作为急性或亚急性特发性间质性肺炎和胶原血管疾病相关性间质性肺炎急性加重患者的预后参数的临床意义

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Background: A prognostic factor for patients with acute or subacute idiopathic interstitial pneumonias (IIPs) or acute exacerbation (AE) of collagen vascular diseases-related interstitial pneumonia (CVD-IP) has not been established. We aimed to determine whether the Charlson comorbidity index (CCI) could serve as a prognostic factor for patients with these patients. Methods: We assessed baseline prognostic factors among patients with acute or subacute IIPs and AE of CVD-IP who were admitted to hospital between January 2014 and December 2017. We classified them as survivors and non-survivors at 3 months and compared their age, sex, CCI, blood parameters [lactate dehydrogenase (LDH), surfactant protein (SP)-D, Krebs von den Lungen-6, and partial pressure of oxygen in arterial blood/fraction of the inspiratory oxygen], high resolution CT (HRCT) scores and treatment. Results: Sixty eight patients with (mean age, 75 years), were assessed. All patients received steroid pulse therapy. We found that 45 of acute or subacute IIPs and 16 of AE of CVD-IP were included. Stepwise multivariate analysis selected CCI (OR, 1.306; 95% CI, 1.090–1.573; P=0.004), serum LDH (OR, 1.003; 95% CI, 1.001–1.005; P=0.002), and sex (OR, 8.555; 95% CI, 1.729–154.978; P=0.038) as significant predictors of 3-month mortality among these patients. Three-month mortality was significantly worse among patients with high (≥4) than low (4) CCI (mortality rates: 63.2% vs. 16.3%, P0.001). Moreover, the composite scoring system including CCI, serum LDH, and sex was acceptable (Bootstrap AUC, 0.859; Bootstrap C-index, 0.747). Conclusions: The composite scoring system including CCI, sex, and serum LDH could be a useful mortality prediction tool for patients with acute or subacute IIPs and AE of CVD-IP requiring steroid pulse therapy.
机译：背景：尚未确定患有胶原蛋白血管疾病相关性间质性肺炎（CVD-IP）的急性或亚急性特发性间质性肺炎（IIPs）或急性发作（AE）的患者的预后因素。我们旨在确定查尔森合并症指数（CCI）是否可以作为这些患者的预后因素。方法：我们评估了2014年1月至2017年12月入院的急性或亚急性IIP和CVD-IP AE患者的基线预后因素。我们将其分为3个月的存活者和非存活者，并比较了他们的年龄，性别，CCI，血液参数[乳酸脱氢酶（LDH），表面活性剂蛋白（SP）-D，Krebs von den Lungen-6和动脉血中的氧分压/吸氧分数），高分辨率CT（HRCT）评分和治疗。结果：评估了68例平均年龄为75岁的患者。所有患者均接受类固醇脉冲治疗。我们发现其中包括45种急性或亚急性IIP和16种CVD-IP AE。逐步多变量分析选择了CCI（OR，1.306; 95％CI，1.090–1.573; P = 0.004），血清LDH（OR，1.003; 95％CI，1.001–1.005; P = 0.002）和性别（OR，8.555;这些患者中3个月死亡率的重要预测指标为95％CI（1.729–154.978; P = 0.038）。 CCI高（≥4）的患者三个月死亡率显着低于低（<4）的患者（死亡率：63.2％对16.3％，P <0.001）。而且，包括CCI，血清LDH和性别在内的综合评分系统是可以接受的（Bootstrap AUC，0.859; Bootstrap C-index，0.747）。结论：包括CCI，性别和血清LDH在内的综合评分系统，对于需要类固醇脉冲治疗的CVD-IP急性或亚急性IIP和AE患者，可能是有用的死亡率预测工具。

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