Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
We aimed to explore the role of antithrombin III (AT-III) activity in diagnosing patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and chronic bronchitis, and its relationship with all-cause mortality of AECOPD patients. We performed univariate and multivariate Cox r...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | COPD |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/15412555.2022.2106200 |
| _version_ | 1797403989030993920 |
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| author | Shuling Zhang Xiaoguang Li Haili Ma Mengpei Zhu Yuequan Zhou Qianqian Zhang Hongxing Peng |
| author_facet | Shuling Zhang Xiaoguang Li Haili Ma Mengpei Zhu Yuequan Zhou Qianqian Zhang Hongxing Peng |
| author_sort | Shuling Zhang |
| collection | DOAJ |
| description | We aimed to explore the role of antithrombin III (AT-III) activity in diagnosing patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and chronic bronchitis, and its relationship with all-cause mortality of AECOPD patients. We performed univariate and multivariate Cox regression analyses of the factors determining all-cause mortality. We recruited 279 patients with AECOPD and 91 with chronic bronchitis. On admission, patients with AECOPD had lower AT-III activity (80.7 vs. 86.35%, p = 0.002) and higher neutrophil percentages (70.12 vs. 66.40%, p = 0.02) than those with chronic bronchitis. The patients who died were older (78 vs. 73 years, p < 0.001); had higher CRP (39.05 vs. 5.65 mg/L, p < 0.001), D-dimer (1.72 vs. 0.46 mg/L, p < 0.001), FIB (3.56 vs. 3.05 g/L, p = 0.01) levels; and exhibited lower AT-III activity (71.29 vs. 82.94%, p < 0.001) than the survivors. The AT-III area under the receiver operating characteristic curve for predicting COPD all-cause mortality was 0.75 (p < 0.001), optimal cutoff point 79.75%, sensitivity 86.8%, and specificity 57.1%. Multivariate Cox regression analyses showed that increased levels of CRP (HR = 1.005, p = 0.02), D-dimer (HR = 1.17, p = 0.01), WBC count (HR = 1.11, p = 0.002), and reduced AT-III activity (HR = 0.97, p = 0.02) were independent prognostic factors for all-cause mortality. Patients with AT-III ≤ 79.75% were 4.52 times (p = 0.001) more likely to die than those with AT-III > 79.75%. AT-III activity was lower in patients with AECOPD than in those with chronic bronchitis and is potentially useful as an independent predictor of all-cause mortality in patients with AECOPD: reduced AT-III activity and increased CRP and D-dimer levels indicate a higher risk of all-cause mortality. |
| first_indexed | 2024-03-09T02:47:42Z |
| format | Article |
| id | doaj.art-b2c4d3504bb64610ac90ed5475db796c |
| institution | Directory Open Access Journal |
| issn | 1541-2555 1541-2563 |
| language | English |
| last_indexed | 2024-03-09T02:47:42Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | COPD |
| spelling | doaj.art-b2c4d3504bb64610ac90ed5475db796c2023-12-05T16:09:50ZengTaylor & Francis GroupCOPD1541-25551541-25632022-12-0119135336410.1080/15412555.2022.21062002106200Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary DiseaseShuling Zhang0Xiaoguang Li1Haili Ma2Mengpei Zhu3Yuequan Zhou4Qianqian Zhang5Hongxing Peng6Department of Pulmonary and Critical Care Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyDepartment of Cardiology, Hubei No.3 People’s Hospital of Jianghan UniversityDepartment of Pulmonary and Critical Care Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyDepartment of Geriatrics Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyDepartment of Pulmonary and Critical Care Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyDepartment of Pulmonary and Critical Care Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyDepartment of Pulmonary and Critical Care Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and TechnologyWe aimed to explore the role of antithrombin III (AT-III) activity in diagnosing patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and chronic bronchitis, and its relationship with all-cause mortality of AECOPD patients. We performed univariate and multivariate Cox regression analyses of the factors determining all-cause mortality. We recruited 279 patients with AECOPD and 91 with chronic bronchitis. On admission, patients with AECOPD had lower AT-III activity (80.7 vs. 86.35%, p = 0.002) and higher neutrophil percentages (70.12 vs. 66.40%, p = 0.02) than those with chronic bronchitis. The patients who died were older (78 vs. 73 years, p < 0.001); had higher CRP (39.05 vs. 5.65 mg/L, p < 0.001), D-dimer (1.72 vs. 0.46 mg/L, p < 0.001), FIB (3.56 vs. 3.05 g/L, p = 0.01) levels; and exhibited lower AT-III activity (71.29 vs. 82.94%, p < 0.001) than the survivors. The AT-III area under the receiver operating characteristic curve for predicting COPD all-cause mortality was 0.75 (p < 0.001), optimal cutoff point 79.75%, sensitivity 86.8%, and specificity 57.1%. Multivariate Cox regression analyses showed that increased levels of CRP (HR = 1.005, p = 0.02), D-dimer (HR = 1.17, p = 0.01), WBC count (HR = 1.11, p = 0.002), and reduced AT-III activity (HR = 0.97, p = 0.02) were independent prognostic factors for all-cause mortality. Patients with AT-III ≤ 79.75% were 4.52 times (p = 0.001) more likely to die than those with AT-III > 79.75%. AT-III activity was lower in patients with AECOPD than in those with chronic bronchitis and is potentially useful as an independent predictor of all-cause mortality in patients with AECOPD: reduced AT-III activity and increased CRP and D-dimer levels indicate a higher risk of all-cause mortality.http://dx.doi.org/10.1080/15412555.2022.2106200copdantithrombin iiithrombinmortality |
| spellingShingle | Shuling Zhang Xiaoguang Li Haili Ma Mengpei Zhu Yuequan Zhou Qianqian Zhang Hongxing Peng Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease COPD copd antithrombin iii thrombin mortality |
| title | Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| title_full | Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| title_fullStr | Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| title_full_unstemmed | Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| title_short | Relationship between Antithrombin III Activity and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| title_sort | relationship between antithrombin iii activity and mortality in patients with acute exacerbation of chronic obstructive pulmonary disease |
| topic | copd antithrombin iii thrombin mortality |
| url | http://dx.doi.org/10.1080/15412555.2022.2106200 |
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