J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 8, Number 7, July 2016, pages 531-536

Comorbidity and Inflammatory Markers May Contribute to Predict Mortality of High-Risk Patients With Chronic Obstructive Pulmonary Disease Exacerbation

**Table 1.** Clinical Characteristics of All COPD Patients
Baseline characteristics	Exacerbation (N) (N = 285)	Exacerbation (Y) (N = 321)	P-value
Values are presented as the mean ± standard deviation unless otherwise indicated. P-values were generated by Student’s t-tests for continuous variables and Chi-squared tests for categorical variables.
Male/female (n)	247/38	266/55	0.246
Age (years)	70.07 ± 8.98	73.14 ± 9.35	0.000
Height (cm)	164 ± 7.34	163 ± 8.63	0.121
Weight (kg)	58.9 ± 10.1	56.5 ± 10.4	0.003
Body mass index (kg/m²)			0.019
BMI < 18.5	42	69
18.5 ≤ BMI < 25	192	214
25 ≤ BMI	52	38
WBC (10³/mm³)	8,035.63 ± 3,145.68	5,969.47 ± 3,711.41	0.002
Serum albumin	4.13 ± 0.43	4.02 ± 0.54	0.007
CRP	1.32 ± 2.53	1.31 ± 1.52	0.984
Pulmonary hypertension	31.04 ± 20.83	33.58 ± 11.96	0.162
Pack-years	41.19 ± 19.09	44.43 ± 29.78	0.211

Table 1. Clinical Characteristics of All COPD Patients

Baseline characteristics

Exacerbation (N) (N = 285)

Exacerbation (Y) (N = 321)

P-value

Male/female (n)

247/38

266/55

0.246

Age (years)

70.07 ± 8.98

73.14 ± 9.35

0.000

Height (cm)

164 ± 7.34

163 ± 8.63

0.121

Weight (kg)

58.9 ± 10.1

56.5 ± 10.4

0.003

Body mass index (kg/m²)

0.019

BMI < 18.5

18.5 ≤ BMI < 25

192

214

25 ≤ BMI

WBC (10³/mm³)

8,035.63 ± 3,145.68

5,969.47 ± 3,711.41

0.002

Serum albumin

4.13 ± 0.43

4.02 ± 0.54

0.007

CRP

1.32 ± 2.53

1.31 ± 1.52

0.984

Pulmonary hypertension

31.04 ± 20.83

33.58 ± 11.96

0.162

Pack-years

41.19 ± 19.09

44.43 ± 29.78

0.211

**Table 2.** Pulmonary Function Test of All COPD Patients
Variable	Exacerbation (N) (N = 285)	Exacerbation (Y) (N = 321)	P-value
Values are presented as the mean ± standard deviation unless otherwise indicated. P-values were generated by Student’s t-tests for continuous variables and Chi-squared tests for categorical variables. FEV₁: forced expiratory volume in 1 s; FVC: forced vital capacity; FEF25-75: forced expiratory flow at 25-75%; GOLD stage: global initiative for chronic obstructive pulmonary disease stage.
Pulmonary function test (post-bronchodilator)
FVC (L)	2.82 ± 1.07	2.30 ± 0.81	0.000
FVC (%)	77.66 ± 18.94	67.43 ± 2.68	0.000
FEV₁ (L)	1.45 ± 0.60	1.10 ± 0.48	0.000
FEV (%)	58.34 ± 20.93	48.10 ± 21.37	0.000
FEV₁/FVC (%)	51.48 ± 11.38	47.74 ± 10.84	0.000
FEF25-75 (%)	25.84 ± 16.21	21.83 ± 14.89	0.002
GOLD stage			0.000
I	43	33
II	144	99
III	83	125
IV	16	64

Table 2. Pulmonary Function Test of All COPD Patients

Variable

Exacerbation (N) (N = 285)

Exacerbation (Y) (N = 321)

P-value

Values are presented as the mean ± standard deviation unless otherwise indicated. P-values were generated by Student’s t-tests for continuous variables and Chi-squared tests for categorical variables. FEV₁: forced expiratory volume in 1 s; FVC: forced vital capacity; FEF25-75: forced expiratory flow at 25-75%; GOLD stage: global initiative for chronic obstructive pulmonary disease stage.

Pulmonary function test (post-bronchodilator)

FVC (L)

2.82 ± 1.07

2.30 ± 0.81

0.000

FVC (%)

77.66 ± 18.94

67.43 ± 2.68

0.000

FEV₁ (L)

1.45 ± 0.60

1.10 ± 0.48

0.000

FEV (%)

58.34 ± 20.93

48.10 ± 21.37

0.000

FEV₁/FVC (%)

51.48 ± 11.38

47.74 ± 10.84

0.000

FEF25-75 (%)

25.84 ± 16.21

21.83 ± 14.89

0.002

GOLD stage

0.000

144

III

125

**Table 3.** Comorbidities of All COPD Patients
Variable	Exacerbation (N) (N = 285)	Exacerbation (Y) (N = 321)	P-value
Other cancer: stomach cancer, bladder cancer, breast cancer, prostate cancer, ovary cancer.
Comorbidities
Diabetes mellitus	30	55	0.012
Hypertension	98	118	0.289
Benign prostate hypertrophy	14	40	0.001
Ischemic heart disease	37	36	0.299
Cerebrovascular accident	9	12	0.432
Lung cancer	4	1	0.153
Other cancer	16	13	0.242

Table 3. Comorbidities of All COPD Patients

Variable

Exacerbation (N) (N = 285)

Exacerbation (Y) (N = 321)

P-value

Other cancer: stomach cancer, bladder cancer, breast cancer, prostate cancer, ovary cancer.

Comorbidities

Diabetes mellitus

0.012

Hypertension

118

0.289

Benign prostate hypertrophy

0.001

Ischemic heart disease

0.299

Cerebrovascular accident

0.432

Lung cancer

0.153

Other cancer

0.242

**Table 4.** Follow-Up Time and Medications of High-Risk Group Who Survived or Died During Follow-Up
	All patients (N = 61)	Non-survivor (N = 21)	Survivor (N = 40)	P-value
AE: acute exacerbation. *Inhaler.
Follow-up time (days)	1,509.67	1,448.38	1,541.85	0.763
Number of AE* (years)	1.46	1.66	1.35	0.143
Medication
Short acting anticholinergic**	12	5	7	0.618
Long acting anticholinergic**	36	11	25	0.340
Long acting β2-agonist**	19	7	12	0.882
Long acting β2-agonist (with inhaled corticosteroid)**	30	10	20	0.665
Theophylline	40	14	26	0.914
Doxophylline	23	6	17	0.235
Systemic corticosteroid	32	14	18	0.160

Table 4. Follow-Up Time and Medications of High-Risk Group Who Survived or Died During Follow-Up

All patients (N = 61)

Non-survivor (N = 21)

Survivor (N = 40)

P-value

AE: acute exacerbation. *Inhaler.

Follow-up time (days)

1,509.67

1,448.38

1,541.85

0.763

Number of AE* (years)

1.46

1.66

1.35

0.143

Medication

Short acting anticholinergic**

0.618

Long acting anticholinergic**

0.340

Long acting β2-agonist**

0.882

Long acting β2-agonist (with inhaled corticosteroid)**

0.665

Theophylline

0.914

Doxophylline

0.235

Systemic corticosteroid

0.160

**Table 5.** Comorbidities of High-Risk Group Who Survived or Died During Follow-Up
	All patients (N = 52)	Non-survivor (N = 18)	Survivor (N = 34)	P-value
Cancer: stomach cancer with bladder cancer, lung cancer, breast cancer, prostate cancer, ovary cancer.
Number of comorbidities	2.21	2.83	1.88	0.020
Comorbidities
Hypertension	23	9	14	0.542
Ischemic heart disease	3	2	1	0.272
Benign prostate hypertrophy	5	0	5	0.150
Diabetes mellitus	21	6	15	0.451
Cancer	6	5	1	0.015
Charlson comorbidity index				0.018
1 (moderate)	23	5	18
2 (severe)	20	6	14
3 (very severe)	9	7	2

Table 5. Comorbidities of High-Risk Group Who Survived or Died During Follow-Up

All patients (N = 52)

Non-survivor (N = 18)

Survivor (N = 34)

P-value

Cancer: stomach cancer with bladder cancer, lung cancer, breast cancer, prostate cancer, ovary cancer.

Number of comorbidities

2.21

2.83

1.88

0.020

Comorbidities

Hypertension

0.542

Ischemic heart disease

0.272

Benign prostate hypertrophy

0.150

Diabetes mellitus

0.451

Cancer

0.015

Charlson comorbidity index

0.018

1 (moderate)

2 (severe)

3 (very severe)

**Table 6.** ESR, CRP and CBC of High-Risk Group Who Survived or Died During Follow-Up
	All patients	Non-survivor	Survivor	P-value
ESR: erythrocyte sedimentation rate; hsCRP: high-sensitivity C-reactive protein.
Hospitalization
ESR	34.1370	31.9371	35.8970	0.532
hsCRP	6.6225	6.4681	6.7386	0.844
WBC (10³/mm³)	11.5505	11.1554	11.8367	0.499
Neutrophil (%)	73.7187	76.7963	71.4901	0.025
Neutrophil count	8,650.7538	8,705.4729	8,611.1296	0.917
Lymphocyte (%)	16.0222	13.5863	17.7863	0.011
Lymphocyte count	1,772.5236	1,450.1176	2,005.9904	0.003
Stable
ESR	24.3009	22.9476	25.0903	0.798
hsCRP	1.0400	1.8273	0.5469	0.025
WBC (10³/mm³)	9.3930	10.2663	8.9251	0.174
Neutrophil (%)	65.4005	70.0139	62.9289	0.036
Neutrophil count	6,310.6560	7,197.2366	5,835.7021	0.107
Lymphocyte (%)	23.4416	18.4410	25.9657	0.005
Lymphocyte count	2,056.1535	1,890.0601	2,145.1321	0.201

Table 6. ESR, CRP and CBC of High-Risk Group Who Survived or Died During Follow-Up

All patients

Non-survivor

Survivor

P-value

ESR: erythrocyte sedimentation rate; hsCRP: high-sensitivity C-reactive protein.

Hospitalization

ESR

34.1370

31.9371

35.8970

0.532

hsCRP

6.6225

6.4681

6.7386

0.844

WBC (10³/mm³)

11.5505

11.1554

11.8367

0.499

Neutrophil (%)

73.7187

76.7963

71.4901

0.025

Neutrophil count

8,650.7538

8,705.4729

8,611.1296

0.917

Lymphocyte (%)

16.0222

13.5863

17.7863

0.011

Lymphocyte count

1,772.5236

1,450.1176

2,005.9904

0.003

Stable

ESR

24.3009

22.9476

25.0903

0.798

hsCRP

1.0400

1.8273

0.5469

0.025

WBC (10³/mm³)

9.3930

10.2663

8.9251

0.174

Neutrophil (%)

65.4005

70.0139

62.9289

0.036

Neutrophil count

6,310.6560

7,197.2366

5,835.7021

0.107

Lymphocyte (%)

23.4416

18.4410

25.9657

0.005

Lymphocyte count

2,056.1535

1,890.0601

2,145.1321

0.201