Gravedad de los pacientes ingresados por epoc agudizada en el ensayo clínico SLICE

  1. S. Marín-Romero 1
  2. Luis Jara Palomares 2
  3. C. Rodríguez Calle 3
  4. E. Tabernero 4
  5. A. Hernando 5
  6. D. Velasco Álvarez 3
  7. B. Pintado Cort 3
  8. A. Pérez Figuera 3
  9. R. Morillo Guerrero 3
  10. D. Jiménez 6
  1. 1 Neumología. Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío, Sevilla, España.
  2. 2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias(CIBERES), Instituto de Salud Carlos III, Madrid, España.
  3. 3 Neumología. Hospital Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España.
  4. 4 Neumología. Hospital Universitario Cruces, Biocruces-Bizkaia, Barakaldo, España.
  5. 5 Neumología. Hospital Doce de Octubre, Madrid, España.
  6. 6 Departamento de Medicina, Universidad de Alcalá, Madrid, España.
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Zeitschrift:
Revista española de patología torácica

ISSN: 1889-7347

Datum der Publikation: 2022

Ausgabe: 34

Nummer: 4

Seiten: 209-216

Art: Artikel

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Andere Publikationen in: Revista española de patología torácica

Zusammenfassung

Introduction: There is little up-to-date information on the clinical characteristics and severity of COPD patients admitted for an exacerbation. Our objective was to characterize patients admitted due to COPD exacerbation according to airflow limitation: mild obstruction (Forced Expiratory Volume in 1 second [FEV1] ≥ 80%); moderate (FEV1 50 - 79%); severe (FEV1 30 - 49%); or very severe (FEV1 <3 0%).Methods: We performed a post-hoc analysis of the multicenter clinical trial SLICE (Significance of Pulmonary Embolism in COPD Exacerbations), which recruited consecutive patients with COPD exacerbation who required admission to 18 Spanish hospitals in the period between September 2014 and July 2020.Results: We included 737 patients, with a mean (SD) age of 70.2 ± 9.9 years, and a predominance of men (73.5%). Spirometry classified patients with mild, moderate, severe, or very severe obstruction in 8%, 31.5%, 45%, and 15.5%, respectively. When comparing the patients according to the degree of obstruction, we observed that the patients with greater airflow obstruction were younger (mild: 71.7 ± 8.8, moderate: 72.4 ± 10, severe: 70.2 ± 9.8, very severe: 66.6 ± 9.2; p < 0.001), had more chronic respiratory failure (37.3% vs. 30.2% vs. 44.9% vs. 64.3%; p < 0.001), had more cyanosis (5.8% vs. 5.9% vs. 8.5% vs. 15.3%; p < 0.001), had a higher percentage of exacerbations and were more tachycardic on arrival at the center hospital (92 ± 16 beats per minute [bpm] vs. 94 ± 18 vs. 96 ± 18 bpm vs. 99 ± 18 bpm; p < 0.001). In addition, arterial blood gases on admission showed a lower pH and a higher pCO2 the more severe the airflow obstruction was (p < 0.001).Conclusion: The severity of the airflow obstruction is associated with the form of presentation and the result of the arterial blood gases of the patient with COPD exacerbation who requires hospital admission.

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