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| Prognostic value of changes in serum uric acid and erythrocyte distribution width in patients with AECOPD |
| Wei hong, Zhang hong, Weng Yun-long, Huang xin |
| Department of Emergency Center, First Affiliated Hospital of Anhui Medical University, Hefei 230001, China |
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Abstract Objective To explore the relationship between the levels of serum uric acid (SUA) and red cell distribution width (RDW) and in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods The patients with AECOPD who were admitted to Lui′an Hospital of Anhui Medical Unversity from January 2016 to February 2018 were selected from the department of emergency medicine, respiratory medicine and critical medicine. Patients with AECOPD were divided into surviving discharged group (n=64) and in-hospital death group (n=41). The laboratory indicators of RDW (%) and SUA (μmoL/L) were collected on the first, the third, the fifth and the seventh day of admission. The best truncation values of RDW and SUA were obtained by ROC curve analysis. Multivariate Logistic regression was used to determine the independent risk factors for in-hospital mortality in AECOPD patients. Results〓 The age and Hb level of the death group were higher than those of the survival and discharge group, and the difference was statistically significant (P<0.05). RDW levels on the third day of admission (AUC 0.784, 95%CI0.694-0.859, the best cut-off value:>13.8), the fifth day (AUC 0.938, 95%CI0.874-0.976, the best cut-off value:>13.6), the seventh day (AUC 0.990, 95%CI0.946-1.000, the best cut-off value: >13.5) all had good predictions of in-hospital mortality in AECOPD patients. SUA levels on the 3rd day of admission (AUC 0.661, 95%CI0.562-0.751, the best cut-off value: >328.7), the 5th day (AUC 0.790, 95%CI 0.700-0.864, the best cut-off value: >323.7), the 7th day (AUC 0.860,95%CI0.777-0.921, the best cut-off value: >327.0) all had good predictions of in-hospital mortality of AECOPD patients. With the extension of admission time, the AUC value increased RDW 0.501<0.784<0.938<0.990, SUA 0.580<0.661<0.790<0.860). Age (HR1.068, 95%CI1.017-1.123), the 7th day of admission RDW (HR10.698, 95%CI2.873-39.813), and the 7th day of admission SUA (HR1.016, 95%CI1.006-1.027) were all independent risk factors for in-hospital mortality in AECOPD patients. Conclusion Increased levels of RDW and SUA are independent risk factors for in-hospital mortality in patients with AECOPD. Continuous detection of SUA and RDW during treatment has important clinical value in judging prognosis, especially on the seventh day after admission, elevated levels of SUA and RDW may predict poor prognosis in patients with AECOPD.
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Corresponding Authors:
Zhang Hong, E-mail: zhanghong20070703@163.com
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