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To study the risk factors for health-related quality of life (HRQoL) changes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) under different multimorbidity patterns.
AECOPD patients in five hospitals in Shanxi Province were selected from September 2021 to September 2023, and 214 patients were finally included. The minimal clinically important differences(MCID) of St George’s Respiratory Questionnaire (SGRQ) was combined to assess the HRQoL of the patients. This study started from multimorbidity (refer to ICD-10), multimorbidity patterns stratification was performed based on latent class analysis (LCA), and then ordered logistic regression analysis was used to analyze the risk factors affecting the change of SGRQ score at 3 months after discharge of patients with different multimorbidity patterns.
Patients were divided into “cardiovascular disease group” and “cor pulmonale low burden group” through potential category analysis. Ordered logistic regression results showed that at 3 months after discharge, the probability of clinically significant increased in SGRQ in patients with high BMI (OR=2.96, 95%CI: 1.09-8.34, P=0.035) and patients with high direct bilirubin (OR=2.96, 95%CI: 1.07-8.35, P=0.037) in the cardiovascular disease group were 2.96 times higher than that of normal patients; the probability of clinically significant increased in SGRQ in patients with high direct bilirubin (OR=3.25, 95% CI:1.35-7.97, P=0.009) and patients with low oxygen saturation (OR=2.35, 95%CI:1.05-5.55, P=0.043) in the cor pulmonale low burden group were 3.25 and 2.35 times higher than those of normal patients (P<0.05).
The prognostic risk factors of AECOPD patients with different multimorbidity patterns are different, and regardless of the multimorbidity patterns, high direct bilirubin is an independent risk factor for HRQoL changes in patients with AECOPD. Moreover clinicians should closely detect in the the abnormal changes in BMI in AECOPD patients with cardiovascular disease.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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