Predictive role of interleukin-6 and CAT score in mechanical ventilation in patients with chronic obstructive pulmonary disease at the acute exacerbation stage in the emergency department / 世界急诊医学杂志(英文)
For a one-year period, among adultpatients in the ED who met the criteria of acute exacerbation of COPD, 158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission. IL-6 level and CAT score were compared between the two groups. The predicted value of IL-6 and CAT score was assessed by logistic regressionanalysis and a receiver operating characteristic (ROC) curve.
RESULTS:
The IL-6 and CAT scores in the 158 MV patients were much higher than those without. IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regressionanalysis (IL-6odds ratio [OR] 1.053, 95% confidence interval [CI] 1.039–1.067, P<0.001; CAT score OR 1.122, 95% CI 1.086–1.159, P<0.001). The combination of IL-6 and CAT scores (area under ROC curve [AUC] 0.826, 95% CI 0.786–0.866, P<0.001) improved the accuracy of predicting MV within 48 hours when compared with IL-6 (AUC 0.752, 95% CI 0.703–0.800, P<0.001) and CAT scores alone (AUC 0.739, 95% CI 0.692–0.786, P<0.001). The sensitivity and specificity were 69.6%, 74.1%, 75.32% and 63.6%, respectively.
CONCLUSION:
The combined of IL-6 and CAT scores is useful for evaluating the risk of COPDpatients at acute exacerbation in ED, and can provide a predictive value for MV or not within 48 hours.