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Factors predict in-hospital treatment failure for patients with COPD exacerbation
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Higher serum levels of C-reactive protein at admission, as well as use of penicillin or cephalosporin, predicted in-hospital treatment failure for patients hospitalized for COPD exacerbation, according to study results.
Presence of cough had a protective role, results showed.
Ernesto Crisafulli, MD, PhD, of the cardiothoracic department and Pneumology and Respiratory Intensive Care Unit at Carlo Poma Hospital in Mantova, Italy, and colleagues prospectively evaluated 110 patients with COPD exacerbation treated with antibiotics and systemic steroids.
After 7 days, researchers divided patients into two groups based on treatment success or treatment failure. Ninety-four patients attained treatment success, whereas 16 patients experienced treatment failure.
The researchers measured inflammatory serum biomarkers upon admission and on day 3. They also gathered mortality and readmission data, and they recorded severity, microbiological, clinical and laboratory data.
Crisafulli and colleagues determined treatment failure was characterized by higher levels upon admission of C-reactive protein, tumor necrosis factor-alpha, interleukin-8, interleukin-10 and procalcitonin, as well as higher serum levels of interleukin-8 and C-reactive protein at day 3.
Researchers also determined the treatment failure group had longer antibiotic therapy duration and hospital length of stay, as well as higher mortality, readmission and total doses of steroids.
Other factors leading to increased risk for treatment failure included penicillin and cephalosporin use (OR = 5.63; 95% CI, 1.26-25.07) and +1 mg/dL of C-reactive protein at admission (OR = 1.07; 95% CI, 1.01-1.13).
Cough upon admission reduced the risk for treatment failure (OR = 0.2; 95% CI, 0.05-0.75). – by Jeff Craven
Disclosure: Healio.com/Pulmonology was unable to confirm the researchers’ relevant financial disclosures at the time of publication.