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Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study

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收录情况： ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 卓越：领军期刊 ◇ 中华系列

作者：
Zhou Chen[1] ; Yi Qun[2,3] ; Luo Yuanming[4] ; Wei Hailong[5] ; Ge Huiqing[6] ; Liu Huiguo[7] ; Li Xianhua[8] ; Zhang Jianchu[9] ; Pan Pinhua[10] ; Yi Mengqiu[11] ; Cheng Lina[11] ; Liu Liang[12] ; Zhang Jiarui[2] ; Peng Lige[2] ; Aili Adila[2] ; Liu Yu[2] ; Pu Jiaqi[2] ; Zhou Haixia[2,*1] ;
机构： [1]West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, China [2]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China [3]Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, Cancer Hospital Affiliated to School of Medicine, UESTC, Chengdu, Sichuan 610041, China [4]State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong 510120, China [5]Department of Respiratory and Critical Care Medicine, People’s Hospital of Leshan, Leshan, Sichuan 614000, China [6]Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China [7]Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China [8]Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Neijiang City, Neijiang, Sichuan 641000, China [9]Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China [10]Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China [11]Department of Emergency, the First People’s Hospital of Jiujiang, Jiujiang, Jiangxi 332000, China [12]Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610041, China.
出处：
DOI： 10.1097/CM9.0000000000002666
ISSN：

关键词： Acute exacerbation of chronic obstructive pulmonary disease Diastolic blood pressure Prognostic factors Inpatients Inhospital mortality

摘要：
Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients.Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes.Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality.Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients.Chinese Clinical Trail Registry, No. ChiCTR2100044625.Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.

基金：
This study was supported by grants from the National Natural Science Foundation of China (No. 82170013), the Sichuan Science and Technology Program (No. 2022YFS0262), and the National Key Research Program of China (No. 2016YFC1304202).
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外文
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中科院(CAS)分区：
出版当年[2023]版：
大类 | 3 区 医学
小类 | 3 区 医学：内科
最新[2023]版：
大类 | 3 区 医学
小类 | 3 区 医学：内科
JCR分区：
出版当年[2023]版：
Q1 MEDICINE, GENERAL & INTERNAL
最新[2023]版：
Q1 MEDICINE, GENERAL & INTERNAL

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, China
共同第一作者：
通讯作者：
通讯机构： [2]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China [*1]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37# Guoxue Xiang, Wuhou District, Chengdu, Sichuan 610041, China
推荐引用方式(GB/T 7714)：
Zhou Chen,Yi Qun,Luo Yuanming,et al.Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study[J].CHINESE MEDICAL JOURNAL.2023,136(8):941-950.doi:10.1097/CM9.0000000000002666.
APA：
Zhou Chen,Yi Qun,Luo Yuanming,Wei Hailong,Ge Huiqing...&Zhou Haixia.(2023).Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study.CHINESE MEDICAL JOURNAL,136,(8)
MLA：
Zhou Chen,et al."Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study".CHINESE MEDICAL JOURNAL 136..8(2023):941-950

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