TY - JOUR

T1 - Prognostic Value of C-Reactive Protein, Leukocytes, and Vitamin D in Severe Chronic Obstructive Pulmonary Disease

AU - Moberg, Mia

AU - Vestbo, Jørgen

AU - Martinez, Gerd

AU - Lange, Peter

AU - Ringbaek, Thomas

PY - 2014

Y1 - 2014

N2 - Inflammatory biomarkers predict mortality and hospitalisation in chronic obstructive pulmonary disease (COPD). Yet, it remains uncertain if biomarkers in addition to reflecting disease severity add new prognostic information on severe COPD. We investigated if leukocytes, C-reactive protein (CRP), and vitamin D were independent predictors of mortality and hospitalisation after adjusting for disease severity with an integrative index, the i-BODE index. In total, 423 patients participating in a pulmonary rehabilitation programme, with a mean value of FEV1 of 38% of predicted, were included. Mean followup was 45 months. During the follow-up period, 149 deaths (35%) were observed and 330 patients (78.0%) had at least one acute hospitalisation; 244 patients (57.7%) had at least one hospitalisation due to an exacerbation of COPD. In the analysis (Cox proportional hazards model) fully adjusted for age, sex, and i-BODE index, the hazard ratio for 1 mg/L increase in CRP was 1.02 (P=0.003) and for 1×10(9)/L increase in leukocytes was 1.43 (P=0.03). Only leukocyte count was significantly associated with hospitalisation. Vitamin D was neither associated with mortality nor hospitalisation. Leukocytes and CRP add little information on prognosis and vitamin D does not seem to be a useful biomarker in severe COPD in a clinical setting.

AB - Inflammatory biomarkers predict mortality and hospitalisation in chronic obstructive pulmonary disease (COPD). Yet, it remains uncertain if biomarkers in addition to reflecting disease severity add new prognostic information on severe COPD. We investigated if leukocytes, C-reactive protein (CRP), and vitamin D were independent predictors of mortality and hospitalisation after adjusting for disease severity with an integrative index, the i-BODE index. In total, 423 patients participating in a pulmonary rehabilitation programme, with a mean value of FEV1 of 38% of predicted, were included. Mean followup was 45 months. During the follow-up period, 149 deaths (35%) were observed and 330 patients (78.0%) had at least one acute hospitalisation; 244 patients (57.7%) had at least one hospitalisation due to an exacerbation of COPD. In the analysis (Cox proportional hazards model) fully adjusted for age, sex, and i-BODE index, the hazard ratio for 1 mg/L increase in CRP was 1.02 (P=0.003) and for 1×10(9)/L increase in leukocytes was 1.43 (P=0.03). Only leukocyte count was significantly associated with hospitalisation. Vitamin D was neither associated with mortality nor hospitalisation. Leukocytes and CRP add little information on prognosis and vitamin D does not seem to be a useful biomarker in severe COPD in a clinical setting.

KW - Aged

KW - Aged, 80 and over

KW - Biological Markers

KW - C-Reactive Protein

KW - Female

KW - Hospitalization

KW - Humans

KW - Leukocyte Count

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Pulmonary Disease, Chronic Obstructive

KW - Risk Factors

KW - Severity of Illness Index

KW - Vitamin D

U2 - 10.1155/2014/140736

DO - 10.1155/2014/140736

M3 - Journal article

C2 - 24587707

VL - 2014

SP - 1

EP - 8

JO - The Scientific World Journal

JF - The Scientific World Journal

SN - 2356-6140

ER -