慢性阻塞性肺疾病1年内再入院危险因素分析

Clinical research of risk factors contributing to one-year readmission of COPD patients

目的分析COPD1年内再入院的危险因素。方法本实验为前瞻性临床研究，研究对象为2007-2008年诊断为COPD的住院患者．实际随访137例，其中男性106例，女性31例。入组时基线平均年龄76岁（最小年龄72岁，最大年龄81岁）：平均体质量指数21．39kg／m^2；平均FEV19／pred为46％（最小29．5％．最大57％）。入组前1年内因AECOPD住院1次、2次及3次以上分别为32例、19例和14例。出院骨平均随访1年。主要研究终点是出院后1年内再入院情况。结果多因素Logistic回归分析结果显示，在对其他因素进行校正岳。既往住院史、C反应蛋白≥3mg/L和PaO2≤60mmHg与再入院相关，OR值分别为5．820、4．940和5．134（P〈0．05）。结论既住1年内住院史、较高的C反应蛋白水平及低氧血症与出院1年内再入院相关。

Objective To investigate the risk factors that contributing to one-year readmission of COPD. Methods This is a prospective cohort study. A total of 137 COPD in patients were enlolled between 2007 and 2008,with 106 male and 31 female. The average BMI at 21.39 kg/m^2,and the average FEV1% pred was 46 （29.5 % to 57 % ）. 32,19 and 14 patients admitted because of AECOPD for once, twice or 3 times separately in the last one year. Patients were followed Lip for an average of one year. Results l.ogistic regression revealed that,after adjusted with other factors, the history of COPD admission in the last year, CRP≥3 mg/L and PaO2≤60 mmHg were the main risk factors contribuling to one year readmission （ OR = 5. 820,4. 940 and 5. 134 separately, P 〈0.05）. Conclusions Past history of COPD admission in last 1 year,high CRP level and hypoxemia associated with 1 year readmission.