AECOPD住院患者3个月内再住院相关风险评估模型的建立  

Evaluating model of re-hospitalization risk of AECOPD patients with in three months

作　　者：李文娟[1] 周宇麒[1] 杨海玲[1] 刘玉颖 王娜娜 郑文争[1] 张天托[1] Li Wenjuan;Zhou Yuqi;Yang Hailing;Liu Yuying;Wang Nana;Zheng Wenzeng;Zhang Tiantuo(Department of Respiratory Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院呼吸内科,广州510630

出　　处：《国际呼吸杂志》2019年第5期350-354,共5页International Journal of Respiration

摘　　要：目的回顾分析慢性阻塞性肺病急性加重(AECOPD)住院患者3个月内再住院治疗的危险因素,加强对患者临床特征的认识,并建立风险评估模型评估其短期再住院风险。方法回顾性分析2007年1月至2013年10月中山大学附属第三医院呼吸内科AECOPD住院患者的临床资料,按照出院后3个月内是否再住院将患者分为两组,采用SPSS软件分析两组在人口学、临床症状、体征、实验室检查等方面的差异,寻找患者再入院危险因素及建立logistic风险评估预测模型。结果纳入的患者中3个月内再住院组90例,未再住院组493例,统计学分析发现年龄、合并房颤、肺炎性病变、高碳酸血症、主肺动脉直径大小,体温升高等指标是AECOPD患者3个月内再住院的独立危险因素,并建立logistics预测模型,获得AECOPD住院患者3个月内再住院的风险预测方程。该模型ROC曲线下面积为0.694(95%CI:0.655~0.732),最佳截断值P=0.2075时,模型敏感度为0.511,特异度为0.826。结论本研究分析了与AECOPD住院患者3个月内再住院相关的临床危险因素,并建立其风险评估模型,为评估此类患者预后和提供干预措施提供临床依据。Objective To analyze retrospectively the risk factors of AECOPD patients rehospitalization in three months,strengthen the knowledge of clinical characteristics of these patients and build a risk evaluating model to assess short-term re-hospitalization risk of them.Methods Retrospective analysis of 583 AECOPD patients in Respiratory Department of the Third Affiliated Hospital of Sun Yat-Sen University from January 2007 to October 2013.Grouping these patients into two groups according to re-hospitalization within three months after discharge.SPSS was used to analyse the differences of demographic data,symptoms,physical examination,blood and functional test in order to find risk factors of re-hospitalizaion and build a model to evaluate the risk.Results There were 90 patients experienced re-hospitalization within three months after discharge,and 493 patients without re-hospitalization within three months.Six independent risk factors were related to re-hospitalization of AECOPD patients,such as age grade,atrial fibrillation.signs of inflammation of pneumonia,hypercapnia,diameter of main pulmonary artery and fever.Based on these factors,we get the model of calculating the risk of AECOPD patients rehospitalization within three months through Logistic regression analysis.The area under curve is 0.694(95% CI:0.6550.732),the best cutoff value of P is 0.207 5,with a sensitivity of 0.511 and a specificity of 0.826.Conclusions We got some clinical factors and a risk evaluating model that are related to re-hospitalization of AECOPD in-patients within three months after discharge,carrying out intervening derections to improve their prognosis.

关 键 词：慢性阻塞性肺疾病急性加重 再住院 风险评估模型 

分 类 号：R563.9[医药卫生—呼吸系统]