ANALYSIS OF RISK FACTORS IN PATIENTS WITH FREQUENT ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Jingjing Zhao^*, Xiaojie Zhang

Department of Respiratory, the PingGu Hospital, Beijing 101200, China

Objective: To investigate the risk factors of frequent acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). 

Methods: The clinical data of 373 patients with chronic obstructive pulmonary disease who were diagnosed and treated in our hospital from January 2018 to December 2020 were retrospectively analyzed. According to the number of exacerbations within a year, patients were divided into frequent acute exacerbation group (≥2 times of exacerbations within a year, n=198) and infrequent acute exacerbation group (<2 times of exacerbations within a year, n=175). The levels of laboratory indicators in the two groups were compared, and logistic regression was used to analyze the risk factors of frequent acute exacerbations in patients with chronic obstructive pulmonary disease. 

Results: There was no significant difference in age, gender, course of disease, smoking history, hypertension, and other general information between the two groups of patients (P>0.05). The history of diabetes and body mass index (BMI) may be related factors for frequent acute exacerbations in patients with chronic obstructive pulmonary disease (P<0.05). There were no significant differences in the total score of chronic obstructive pulmonary disease assessment test (CAT), white blood cell count (WBC), platelet count, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) between the two groups of patients (P>0.05). Immunoglobulin E (IgE), arterial blood CO₂ partial pressure (PaCO₂), Modified British Medical Research Council Dyspnea Scale (mMRC), neutrophil count (NEUT), lymphocyte count (LY), neutrophil/lymphocyte ratio (NLR), Hamilton anxiety scale (HAMA) score are likely to be factors influencing frequent acute exacerbation in patients with chronic obstructive pulmonary disease (P<0.05). The index with P<0.05 in univariate analysis was included in the multivariate Logistic regression model, and the multiple linear regression analysis was carried out. The results showed that high NLR levels, diabetes mellitus, and high PaCO₂ levels were independent risk factors for frequent acute exacerbations in patients with chronic obstructive pulmonary disease. (P<0.05). 

Conclusion: BMI, IgE, mMRC score and HAMA score may be the factors affecting the frequent acute exacerbation of COPD patients. High NLR level, diabetes mellitus, and high PaCO₂ level are independent risk factors affecting the frequent acute exacerbation of COPD patients.