Standardized evaluation of lung congestion during COPD exacerbation better identifies patients at risk of dying

International Journal of Chronic Obstructive Pulmonary Disease
Arne Didrik HøisethVidar Søyseth

Abstract

Congestive heart failure is underdiagnosed in patients with chronic obstructive pulmonary disease (COPD). Pulmonary congestion on chest radiograph at admission for acute exacerbation of COPD (AECOPD) is associated with an increased risk of mortality. A standardized evaluation of chest radiographs may enhance prognostic accuracy. We aimed to evaluate whether a standardized, liberal assessment of pulmonary congestion is superior to the routine assessment in identifying patients at increased risk of long-term mortality, and to investigate the association of heart failure with N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations. This was a prospective cohort study of 99 patients admitted for AECOPD. Chest radiographs obtained on admission were routinely evaluated and then later evaluated by blinded investigators using a standardized protocol looking for Kerley B lines, enlarged vessels in the lung apex, perihilar cuffing, peribronchial haze, and interstitial or alveolar edema, defining the presence of pulmonary congestion. Adjusted associations with long-term mortality and NT-proBNP concentration were calculated. The standardized assessment was positive for pulmonary congestion in 32 of the 195 radiographs...Continue Reading

References

Sep 29, 2001·Journal of Internal Medicine·I BuajordetT Hilberg
Mar 10, 2004·The American Journal of Medicine·Cathrine W KnudsenAlan S Maisel
Oct 21, 2005·Chest·Laetitia HuiartSamy Suissa
May 29, 2007·COPD·Saher B ShakerJann Mortensen
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Feb 9, 2011·COPD·Saher B ShakerAsger Dirksen
Mar 16, 2011·European Journal of Internal Medicine·Araceli Molina MedinaJuan I Pérez-Calvo
Jun 28, 2011·The European Respiratory Journal·A MacchiaG Tognoni

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Citations

May 3, 2016·Expert Review of Respiratory Medicine·Konstantinos KostikasFrancesco Patalano
Sep 2, 2016·The European Respiratory Journal·Jose Luis Lopez-CamposCiro Casanova
Aug 18, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Bojidar A RangelovJohn R Hurst

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