Primary construction of pre⁃hospital screening model for chronic obstructive pulmonary disease
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    Abstract:

    Objective:By observing and studying the specific related factors of patients with chronic obstructive pulmonary disease(COPD),a pre-hospital screening model of COPD was established to improve the implementation rate of pulmonary function examination in high-risk groups of COPD,so as to reduce the rate of missed diagnosis and mortality of COPD. Methods:Total 68 patients with stable COPD and 40 patients in the control group were enrolled. Their basic data were collected,and COPD assessment test(CAT),pulse rate and finger pulse oxygen measurement during exercise and pulmonary function test were performed at the same time. Logistic regression analysis was used to determine the independent variables related to COPD,and COPD screening model was constructed,which was corrected by Hosmer-Lemeshow test and discriminated by area under receiver operating characteristic curve(AUROC). Results:There were significant differences in age,smoking index,body mass index(BMI),CAT score,lowest finger pulse oxygen(SPO2L)and highest pulse rate between the control group and stable COPD patients. Smoking index,CAT score and SPO2L constituted the screening model,and used to estimate the probability of COPD(PCOPD).The best threshold of PCOPD was 57.1%. The best thresholds of influencing factors in the screening model were smoking index ≥220 cigarette-years,CAT score ≥ 7.5 and SPO2L ≤ 93.5%. The AUROC of the model was 0.938 with strong discriminant ability . The model correction was good with the Hosmer-Lemeshow fitting test P=0.789. Conclusion:Smoking index,CAT score and SPO2L constitute the pre-hospital screening model for COPD,which has good differentiation and correction. When PCOPD ≥ 57.1%,it is helpful for doctors to effectively screen high-risk patients with COPD,and it is recommended to carry out lung function test to confirm the diagnosis, so as to reduce the rate of missed diagnosis of COPD. When smoking index ≥ 220 cigarette-years,CAT score ≥ 7.5 and SPO2L ≤ 93.5%,it has good guiding significance for COPD screening.

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李瑞久,陈良玉,李媛媛,倪艾珺,孙培莉.慢性阻塞性肺疾病院前筛查模型的初级构建[J].南京医科大学学报(自然科学版英文版),2021,(11):1620-1625.

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History
  • Received:March 29,2021
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  • Online: December 13,2021
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