Abstract:

Objective To investigate the risk factor of acute exacerbation in near future of elderly COPD patients in a stable stage and construct prediction model to provide more reference for early identification of high-risk groups of unplanned hospitalization and formulation of more active and effective intervention programs. Methods 654 elderly patients with COPD in stable stage were retrospectively chosen in the period from January 2018 to June 2022 in our hospital and grouped according to whether acute exacerbation occurred within 6 months of follow-up or not into with exacerbation group （134 cases） and non-exacerbation group （520 cases）. Univariate and multivariate methods were used to analyze the independent influencing factors of short-term acute exacerbations risk in elderly COPD stable patients， and the prediction model based on the above independent influencing factors was constructed and the clinical efficacy of prediction model for short-term acute exacerbations risk was further evaluated. Results Univariate analysis showed that gender， body mass index， cough， FEV1， FVC， the frequency and duration of acute exacerbations in recent 1 year may be related to the occurrence of acute exacerbations in elderly patients with COPD in stable stage （P < 0.05）. Multivariate analysis results of Logistic regression model showed that gender， body mass index， FEV1， FVC， the number and duration of acute exacerbations in recent 1 year were independent factors influencing the risk of acute exacerbations in elderly patients with COPD in stable stage （P < 0.05）. The model equation was constructed according to the independent variable partial regression coefficient： near-term acute exacerbation risk ［Logit （p/1-p）］=-2.981 + 0.642× sex -0.517× body mass index +0.316× the number of acute exacerbations in recent 1 year + 0.028× duration of acute exacerbation in recent 1 year -0.621×FEV1. ROC curve analysis results showed that the area under the curve for predicting the risk of acute exacerbation in near future of elderly COPD patients in stable stage was 0.84 （95%CI： 0.79 - 0.92）， the optimal cut-off value was 0.23， and the sensitivity and specificity were 82.71% and 70.85%， respectively. Conclusion The occurrence of acute exacerbations in aged COPD patients in a stable stage was related to sex， body mass index， FEV1， FVC， the number and duration of acute exacerbations in recent 1 year and the prediction model based on the above independent factors can accurately predict the risk of acute exacerbations in the near future.

Key words: chronic obstructive pulmonary disease, stable period, acute exacerbation, prediction model