Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease.

Hinke, Clemens F; Jörres, Rudolf A; Alter, Peter; Bals, Robert; Bornitz, Florian; Kreuter, Michael; Herth, Felix J F; Kahnert, Kathrin; Kellerer, Christina; Watz, Henrik; Budweiser, Stephan; Trudzinski, Franziska C

doi:10.1159/000513440

2021

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Title:: Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease.
Document type:: Journal Article
Author(s):: Hinke, Clemens F; Jörres, Rudolf A; Alter, Peter; Bals, Robert; Bornitz, Florian; Kreuter, Michael; Herth, Felix J F; Kahnert, Kathrin; Kellerer, Christina; Watz, Henrik; Budweiser, Stephan; Trudzinski, Franziska C
Abstract:: BACKGROUND: Oxygenated hemoglobin(OxyHem) is a simple-to-measure marker of oxygen content capable of predicting all-cause mortality in stable chronic obstructive pulmonary disease (COPD). OBJECTIVES: We aimed to analyze its predictive value during acute exacerbations of COPD (AECOPD). METHODS: In this retrospective study, data from 227 patients discharged after severe AECOPD at RoMed Clinical Center Rosenheim, Germany, between January 2012 and March 2018, was analyzed. OxyHem (hemoglobin concentration [Hb] × fractional SpO2, g/dL) was calculated from oxygen saturation measured by pulse oximetry and hemoglobin assessed within 24 h after admission. The follow-up (1.7 ± 1.5 years) covered all-cause mortality, including readmissions for severe AECOPD. RESULTS: During the follow-up period, 127 patients died, 56 due to AECOPD and 71 due to other reasons. Survivors and non-survivors showed differences in age, FVC % predicted, C-reactive protein, hemoglobin, Cr, Charlson Comorbidity Index (CCI), and OxyHem (p < 0.05 each). Significant independent predictors of survival were BMI, Cr or CCI, FEV1 % predicted or FVC % predicted, Hb, or OxyHem. The predictive value of OxyHem (p = 0.006) was superior to that of Hb or SpO2 and independent of oxygen supply during blood gas analysis. OxyHem was also predictive when using a cutoff value of 12.1 g/dL identified via receiver operating characteristic curves in analyses including either the CCI (hazard ratio 1.85; 95% CI 1.20, 2.84; p = 0.005) or Cr (2.04; 95% CI 1.35, 3.10; p = 0.001) as covariates. CONCLUSION: The concentration of OxyHem provides independent, easy-to-assess information on long-term mortality risk in COPD, even if measured during acute exacerbations. It therefore seems worth to be considered for broader clinical use.
Journal title abbreviation:: Respiration
Year:: 2021
Journal volume:: 100
Journal issue:: 5
Pages contribution:: 387-394
Fulltext / DOI:: doi:10.1159/000513440
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/33550305
Print-ISSN:: 0025-7931
TUM Institution:: Lehrstuhl für Allgemeinmedizin (Prof. Schneider) (keine SAP-Zuordnung!)
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