Predictors of an unfavorable course of chronic obstructive pulmonary disease

The aim of the study was to compare clinical, instrumental and laboratory parameters in surviving and deceased patients with COPD during 1 year of follow-up and identify risk factors for an unfavorable prognosis. Materials and methods. 100 patients with acute COPD were included (median age: 60.5 years). The statistical significance of differences in clinical and instrumental parameters was assessed, and a correlation analysis was performed. A predictive model of an unfavorable outcome is built on the basis of binary logistic regression. Results. An unfavorable outcome of the disease was noted in 10% of patients. The constructed regression model is statistically significant (p<0.01). Factors influencing a high risk of death within 1 year: melatonin level (OR=0.953; 95% CI: 0.950–0.999; p=0.1101), CAT test values (OR=0.349; 95% CI: 0.101–1.206; p=0.096), mMRC (OR=0.014; 95% CI: 0.0003–0.625; p=0.028), concentration of 8isoprostane (OR=0.983; 95% CI: 0.957–1.010; p=0.231), values of MOC25 (OR=1.211; 95% CI: 0.881– 1.664; p=0.237) and TCX (OR=0.012; 95% CI: 0.964–1.063; p=0.625). A significant negative dynamics of parameters in deceased patients and the relationship between the number of hospitalizations and clinical and instrumental parameters (p<0.001) were revealed. Conclusion. Determination of melatonin and 8-isoprostane concentrations in patients with COPD helps to clarify the prognosis of the disease, substantiates the need for personalized correction of therapy and reduce the risk of an adverse outcome.

COPD, adverse outcome, biomarkers, melatonin, 8-isoprostane, oxidative stress