The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD
Abstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary di...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02751-7 |
| _version_ | 1797416278157164544 |
|---|---|
| author | Shiyi He Shiyu Wu Tianwei Chen Weina Huang Aiping Yu Chao Cao |
| author_facet | Shiyi He Shiyu Wu Tianwei Chen Weina Huang Aiping Yu Chao Cao |
| author_sort | Shiyi He |
| collection | DOAJ |
| description | Abstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain. Methods In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD. Results The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70–0.86, P < 0.0001, sensitivity: 60.4%, specificity: 86.8%). The nomogram model, the C index, calibration plot, decision curve analysis, and clinical impact curve all indicate the model’s good predictive performance. The observed decrease in the proportions of CD4+CD8+ T cells appears to be correlated with more unfavorable outcomes. Conclusions The nomogram model, developed to forecast respiratory failure in patients with AECOPD, utilizing variables such as home oxygen therapy, CAT score, and CD4+CD8+ T cells%, demonstrated a high level of practicality in clinical settings. CD4+CD8+ T cells serve as a reliable and readily accessible predictor of AECOPD, exhibiting greater stability compared to other indices. It is less susceptible to subjective influences from patients or physicians. This model facilitated personalized estimations, enabling healthcare professionals to make informed decisions regarding preventive interventions. |
| first_indexed | 2024-03-09T06:01:07Z |
| format | Article |
| id | doaj.art-4c1e5278c027497cafdc3621575d7be1 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-09T06:01:07Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-4c1e5278c027497cafdc3621575d7be12023-12-03T12:08:53ZengBMCBMC Pulmonary Medicine1471-24662023-11-0123111510.1186/s12890-023-02751-7The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPDShiyi He0Shiyu Wu1Tianwei Chen2Weina Huang3Aiping Yu4Chao Cao5Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo UniversityDepartment of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo UniversityDepartment of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo UniversityDepartment of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo UniversityDepartment of Nursing, The First Affiliated Hospital of Ningbo UniversityDepartment of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo UniversityAbstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain. Methods In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD. Results The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70–0.86, P < 0.0001, sensitivity: 60.4%, specificity: 86.8%). The nomogram model, the C index, calibration plot, decision curve analysis, and clinical impact curve all indicate the model’s good predictive performance. The observed decrease in the proportions of CD4+CD8+ T cells appears to be correlated with more unfavorable outcomes. Conclusions The nomogram model, developed to forecast respiratory failure in patients with AECOPD, utilizing variables such as home oxygen therapy, CAT score, and CD4+CD8+ T cells%, demonstrated a high level of practicality in clinical settings. CD4+CD8+ T cells serve as a reliable and readily accessible predictor of AECOPD, exhibiting greater stability compared to other indices. It is less susceptible to subjective influences from patients or physicians. This model facilitated personalized estimations, enabling healthcare professionals to make informed decisions regarding preventive interventions.https://doi.org/10.1186/s12890-023-02751-7Chronic obstructive pulmonary diseaseAcute exacerbationsAutoimmunityPrediction nomogramCD4+CD8+ T cellsCOPD assessment test |
| spellingShingle | Shiyi He Shiyu Wu Tianwei Chen Weina Huang Aiping Yu Chao Cao The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD BMC Pulmonary Medicine Chronic obstructive pulmonary disease Acute exacerbations Autoimmunity Prediction nomogram CD4+CD8+ T cells COPD assessment test |
| title | The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD |
| title_full | The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD |
| title_fullStr | The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD |
| title_full_unstemmed | The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD |
| title_short | The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD |
| title_sort | predictive value of baseline symptom score and the peripheral cd4cd8 double positive t cells in patients with aecopd |
| topic | Chronic obstructive pulmonary disease Acute exacerbations Autoimmunity Prediction nomogram CD4+CD8+ T cells COPD assessment test |
| url | https://doi.org/10.1186/s12890-023-02751-7 |
| work_keys_str_mv | AT shiyihe thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT shiyuwu thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT tianweichen thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT weinahuang thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT aipingyu thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT chaocao thepredictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT shiyihe predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT shiyuwu predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT tianweichen predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT weinahuang predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT aipingyu predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd AT chaocao predictivevalueofbaselinesymptomscoreandtheperipheralcd4cd8doublepositivetcellsinpatientswithaecopd |