Tags

Type your tag names separated by a space and hit enter

Serum inflammatory biomarkers and clinical outcomes of COPD exacerbation caused by different pathogens.
Int J Chron Obstruct Pulmon Dis. 2017; 12:1625-1630.IJ

Abstract

BACKGROUND AND OBJECTIVE

COPD exacerbation is characterized by worsening of symptoms, warranting change in treatment. Systemic and airway inflammation play roles in the pathogenesis of COPD exacerbation. We hypothesized whether increased serum inflammatory biomarkers are associated with the clinical outcomes of COPD exacerbation caused by different infectious pathogens.

METHODS

COPD patients with exacerbation were recruited from a hospital emergency department during 2014-2015. Serum procalcitonin (PCT) and C-reactive protein (CRP) were measured. Dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) score was calculated for predicting mortality. Multiplex polymerase chain reaction was carried out for respiratory viral assay from nasopharyngeal swabs, and sputum bacterial culture was also performed. Hospital mortality, invasive mechanical ventilation requirement, and length of hospital stay (LOS) were evaluated, and their associations with clinical characteristics, DECAF score, and serum biomarkers were examined.

RESULTS

A total of 62 COPD patients were enrolled. These patients were classified as Global Initiative for Obstructive Lung Disease (GOLD) stage 2, 3, and 4 in 12.9%, 6.4%, and 80.7% of cases, respectively. Isolated bacterial exacerbation was recovered in 30.6% of exacerbation episodes: Klebsiella pneumoniae was the most commonly identified bacteria. Viral pathogens and coinfections were noted in 9.6% and 16.1% of exacerbated patients, respectively. Influenza was the most commonly detected viral pathogen. Serum biomarkers and DECAF score for viruses, bacteria, coinfection, and noninfectious causes of exacerbations were similar. Neither DECAF score nor serum biomarkers were able to differentiate patients with and without mortality or requiring mechanical ventilation. Increased serum PCT was noted in patients with LOS ≥7 days when compared with those with LOS <7 days (0.38 ng/mL vs 0.1 ng/mL; P=0.035).

CONCLUSION

Increased serum PCT is associated with longer LOS in COPD exacerbation. However, CRP and DECAF score play limited roles in predicting clinical outcome and lack an association with causes of exacerbation.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine.Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28615935

Citation

Kawamatawong, Theerasuk, et al. "Serum Inflammatory Biomarkers and Clinical Outcomes of COPD Exacerbation Caused By Different Pathogens." International Journal of Chronic Obstructive Pulmonary Disease, vol. 12, 2017, pp. 1625-1630.
Kawamatawong T, Apiwattanaporn A, Siricharoonwong W. Serum inflammatory biomarkers and clinical outcomes of COPD exacerbation caused by different pathogens. Int J Chron Obstruct Pulmon Dis. 2017;12:1625-1630.
Kawamatawong, T., Apiwattanaporn, A., & Siricharoonwong, W. (2017). Serum inflammatory biomarkers and clinical outcomes of COPD exacerbation caused by different pathogens. International Journal of Chronic Obstructive Pulmonary Disease, 12, 1625-1630. https://doi.org/10.2147/COPD.S132132
Kawamatawong T, Apiwattanaporn A, Siricharoonwong W. Serum Inflammatory Biomarkers and Clinical Outcomes of COPD Exacerbation Caused By Different Pathogens. Int J Chron Obstruct Pulmon Dis. 2017;12:1625-1630. PubMed PMID: 28615935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum inflammatory biomarkers and clinical outcomes of COPD exacerbation caused by different pathogens. AU - Kawamatawong,Theerasuk, AU - Apiwattanaporn,Apitch, AU - Siricharoonwong,Warisara, Y1 - 2017/05/31/ PY - 2017/6/16/entrez PY - 2017/6/16/pubmed PY - 2018/4/10/medline KW - COPD exacerbation KW - bacteria KW - biomarkers KW - inflammation KW - outcome KW - viruses SP - 1625 EP - 1630 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 12 N2 - BACKGROUND AND OBJECTIVE: COPD exacerbation is characterized by worsening of symptoms, warranting change in treatment. Systemic and airway inflammation play roles in the pathogenesis of COPD exacerbation. We hypothesized whether increased serum inflammatory biomarkers are associated with the clinical outcomes of COPD exacerbation caused by different infectious pathogens. METHODS: COPD patients with exacerbation were recruited from a hospital emergency department during 2014-2015. Serum procalcitonin (PCT) and C-reactive protein (CRP) were measured. Dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) score was calculated for predicting mortality. Multiplex polymerase chain reaction was carried out for respiratory viral assay from nasopharyngeal swabs, and sputum bacterial culture was also performed. Hospital mortality, invasive mechanical ventilation requirement, and length of hospital stay (LOS) were evaluated, and their associations with clinical characteristics, DECAF score, and serum biomarkers were examined. RESULTS: A total of 62 COPD patients were enrolled. These patients were classified as Global Initiative for Obstructive Lung Disease (GOLD) stage 2, 3, and 4 in 12.9%, 6.4%, and 80.7% of cases, respectively. Isolated bacterial exacerbation was recovered in 30.6% of exacerbation episodes: Klebsiella pneumoniae was the most commonly identified bacteria. Viral pathogens and coinfections were noted in 9.6% and 16.1% of exacerbated patients, respectively. Influenza was the most commonly detected viral pathogen. Serum biomarkers and DECAF score for viruses, bacteria, coinfection, and noninfectious causes of exacerbations were similar. Neither DECAF score nor serum biomarkers were able to differentiate patients with and without mortality or requiring mechanical ventilation. Increased serum PCT was noted in patients with LOS ≥7 days when compared with those with LOS <7 days (0.38 ng/mL vs 0.1 ng/mL; P=0.035). CONCLUSION: Increased serum PCT is associated with longer LOS in COPD exacerbation. However, CRP and DECAF score play limited roles in predicting clinical outcome and lack an association with causes of exacerbation. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/28615935/Serum_inflammatory_biomarkers_and_clinical_outcomes_of_COPD_exacerbation_caused_by_different_pathogens_ L2 - https://dx.doi.org/10.2147/COPD.S132132 DB - PRIME DP - Unbound Medicine ER -