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Yu R, Kong X, Li Y. Optimizing the Diagnostic Algorithm for Pulmonary Embolism in Acute COPD Exacerbation Using Fuzzy Rough Sets and Support Vector Machine. COPD 2023; 20:1-8. [PMID: 36594682 DOI: 10.1080/15412555.2022.2139671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Aiming to optimize the diagnosis of pulmonary embolism (PE) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), we conducted a retrospective study enrolling 185 AECOPD patients, of whom 90 were diagnosed with PE based on computed tomography pulmonary angiography (CTPA). Ten characteristic indicators and 27 blood indicators were extracted for each patient. First, we quantified the importance of each indicator for diagnosing PE in AECOPD using fuzzy rough sets (FRS) and selected the more important indicators to construct a support vector machine (SVM) diagnosis model called FRS-SVM. The performance of the proposed diagnosis model on the test sets was compared to that of the logistic regression model. The average accuracy and area under the curve (AUC) of the proposed model for the test sets in 10 independent trials were 94.67% and 0.944, respectively, compared to 80.41% and 0.809 for the logistic regression model. Thus, we validated the higher accuracy and stability of the FRS-SVM for PE diagnosis in patients with AECOPD. This model improved the prediction probability before CTPA and can be used in clinical practice to help doctors make decisions.
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Affiliation(s)
- Rui Yu
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, China
| | - Xianghua Kong
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, China
| | - Youlun Li
- Department of Pulmonary and Critical care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Yan S, Kong J, Zhao ZF, Yao H. The prognostic importance of red blood cell distribution width for gastric cancer: a systematic review and meta-analysis. Transl Cancer Res 2023; 12:1816-1825. [PMID: 37588748 PMCID: PMC10425649 DOI: 10.21037/tcr-23-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/11/2023] [Indexed: 08/18/2023]
Abstract
Background For cancer patients, red blood cell distribution width (RDW) is a readily accessible and cost-effective preoperative prognostic predictor. This study aimed to determine whether RDW is a predictive factor for individuals undergoing radical surgery for gastric cancer (GC). Methods A literature search was performed to select relevant studies for inclusion in the subsequent meta-analysis. Relevant data were pooled to assess the association between RDW and GC results, including overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS), as well as clinicopathological features. Results The meta-analysis and systemic review included data from 8 studies comprising 1,587 individuals diagnosed with GC. In this context, RDW refers to the coefficient of variation of RDW (RDW-CV). A high level of RDW-CV was significantly associated with older age [odds ratio (OR) =2.25; 95% confidence interval (CI): 1.72-2.94; P<0.00001], larger tumor diameter (OR =1.90; 95% CI: 1.42-2.56; P<0.0001), and vascular invasion (OR =2.22; 95% CI: 1.10-4.49; P=0.03). After hazard ratios (HRs) and 95% CIs were pooled, RDW-CV was found to be an independent prognostic factor of OS (HR =1.79; 95% CI: 1.21-2.66; I2=85%; P=0.004), DFS (HR =1.81; 95% CI: 1.37-2.39; I2=0%; P<0.0001), and CSS (HR =2.73; 95% CI: 1.36-5.49; I2=0%; P=0.005) in patients with GC. Conclusions The association between high levels of RDW-CV and poor survival in GC suggests that RDW-CV may be a viable prognostic indicator for patients with GC.
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Affiliation(s)
- Shuai Yan
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Jian Kong
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Zheng-Fei Zhao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Hui Yao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
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Cai S, Li Y, Sun B, Wang K, Wan Z, Yang D, Tian X, Wu L, Zhu R. Red blood cell distribution width combined with age as a predictor of acute ischemic stroke in stable COPD patients. Front Neurol 2023; 14:1165181. [PMID: 37342782 PMCID: PMC10277555 DOI: 10.3389/fneur.2023.1165181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Aim This retrospective study aimed to investigate the independent clinical variables associated with the onset of acute cerebral ischemic stroke (AIS) in patients with stable chronic obstructive pulmonary disease (COPD). Method A total of 244 patients with COPD who had not experienced a relapse within 6 months were included in this retrospective study. Of these, 94 patients hospitalized with AIS were enrolled in the study group, and the remaining 150 were enrolled in the control group. Clinical data and laboratory parameters were collected for both groups within 24 h after hospitalization, and the data of the two groups were statistically analyzed. Results The levels of age, white blood cell (WBC), neutrophil (NEUT), glucose (GLU), prothrombin time (PT), albumin (ALB), and red blood cell distribution width (RDW) were different in the two groups (P < 0.01). Logistic regression analysis showed that age, WBC, RDW, PT, and GLU were independent risk factors for the occurrence of AIS in patients with stable COPD. Age and RDW were selected as new predictors, and the receiver operating characteristic curves (ROC) were plotted accordingly. The areas under the ROC curves of age, RDW, and age + RDW were 0.7122, 0.7184, and 0.7852, respectively. The sensitivity was 60.5, 59.6, and 70.2%, and the specificity was 72.4, 86.0, and 60.0%, respectively. Conclusion The combination of RDW and age in patients with stable COPD might be a potential predictor for the onset of AIS.
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Affiliation(s)
- Shikun Cai
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Yao Li
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Bo Sun
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Kai Wang
- Department of Rheumatology and Immunology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Zongren Wan
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Dan Yang
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Xiangyang Tian
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Liao Wu
- Department of Neurology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Rong Zhu
- Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian, China
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Zinellu A, Mangoni AA. The Emerging Clinical Significance of the Red Cell Distribution Width as a Biomarker in Chronic Obstructive Pulmonary Disease: A Systematic Review. J Clin Med 2022; 11:jcm11195642. [PMID: 36233510 PMCID: PMC9571455 DOI: 10.3390/jcm11195642] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
There is an intense focus on the identification of novel biomarkers of chronic obstructive pulmonary disease (COPD) to enhance clinical decisions in patients with stable disease and acute exacerbations (AECOPD). Though several local (airway) and circulatory inflammatory biomarkers have been proposed, emerging evidence also suggests a potential role for routine haematological parameters, e.g., the red cell distribution width (RDW). We conducted a systematic literature search in PubMed, Web of Science, and Scopus, from inception to April 2022, for articles investigating the diagnostic and prognostic role of the RDW in stable COPD and AECOPD. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Significant associations between the RDW and the presence and severity of disease, outcomes (mortality, hospital readmission), and other relevant clinical parameters (right heart failure, pulmonary arterial hypertension) were reported in 13 out of 16 studies in stable COPD (low risk of bias in 11 studies), and 17 out of 21 studies of AECOPD (low risk of bias in 11 studies). Pending further research, our systematic review suggests that the RDW might be useful, singly or in combination with other parameters, for the diagnosis and risk stratification of patients with stable COPD and AECOPD (PROSPERO registration number: CRD42022348304).
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Flinders Drive, Bedford Park, SA 5042, Australia
- Correspondence:
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Yang R, Liu G, Deng C. Pulmonary embolism with chronic obstructive pulmonary disease. Chronic Dis Transl Med 2021; 7:149-156. [PMID: 34505015 PMCID: PMC8413125 DOI: 10.1016/j.cdtm.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Indexed: 11/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.
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Affiliation(s)
- Ruohan Yang
- Institute of Respiratory Disease, Fujian Medical University, Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
| | - Guiqing Liu
- The Hammersmith Hospital, London W12 0NN, United Kingdom
| | - Chaosheng Deng
- Institute of Respiratory Disease, Fujian Medical University, Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
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Fu X, Zhong Y, Xu W, Ju J, Yu M, Ge M, Gu X, Chen Q, Sun Y, Huang H, Shen L. The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review. PLoS One 2021; 16:e0256480. [PMID: 34473738 PMCID: PMC8412363 DOI: 10.1371/journal.pone.0256480] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies. METHODS We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively. RESULTS A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97-23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06-5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51-4.00), higher heart rates (MD = 20.51, 95% CI: 4.95-36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01-4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80-2.23), WBC counts (MD = 1.42, 95% CI: 0.14-2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43-3.50). CONCLUSIONS The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE. PROSPERO REGISTRATION NUMBER CRD42021226568.
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Affiliation(s)
- Xiaofang Fu
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Yonghong Zhong
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Wucheng Xu
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Jiangang Ju
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Min Yu
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Minjie Ge
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Xiaofei Gu
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Qingqing Chen
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Yibo Sun
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
| | - Huaqiong Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Linfeng Shen
- Department of Respiratory, First People’s Hospital of Yuhang, Hangzhou, China
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Zhu M, Dai L, Wan L, Zhang S, Peng H. Dynamic Increase of Red Cell Distribution Width Predicts Increased Risk of 30-Day Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:393-400. [PMID: 33658772 PMCID: PMC7917314 DOI: 10.2147/copd.s291833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Studies have demonstrated that red blood cell distribution width (RDW) is closely associated with the prognosis of patients with chronic obstructive pulmonary disease (COPD). In addition, the dynamic changes in RDW appear to play an important role. Thus, we aimed to investigate the relationship between dynamic changes in RDW and 30-day all-cause readmission of patients with acute exacerbation of COPD (AECOPD). Methods In this retrospective cohort study, we enrolled patients with AECOPD hospitalized in the Department of Respiratory Medicine in Liyuan Hospital (Wuhan China), a tertiary, university-affiliated, public hospital. Patients with AECOPD were divided into three groups based on their RDW values after the first and fourth days of admission. The normal range for RDW is 10-15%. Patients with normal RDW values were included in the normal group. Patients with an RDW value >15% on the first day, which subsequently decreased by >2% on the fourth day was included in the decreased group. The increased group was comprised of patients with an RDW value >15% on the first day which continued to increase, or those with a normal RDW value on the first day which increased >15% on the fourth day. Results A total of 239 patients (age: 72 years [range: 64-81 years]; male: n=199 [83.3%]) were included. There were 108, 72, and 59 patients in the RDW normal, decreased, and increased groups, respectively; the 30-day all-cause readmission rate was 9.3%, 9.7%, 27.1%, respectively; (p=0.003), being noticeably higher in the RDW increased group. Dynamic increase of RDW (OR:3.45, 95% CI: 1.39-8.58, p= 0.008) was independently correlated with 30-day all-cause readmission of patients with AECOPD. Conclusion The dynamic increase of RDW is an independent prognostic factor of 30-day all-cause readmission of patients with AECOPD.
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Affiliation(s)
- Mengpei Zhu
- Department of Respiratory Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Lisong Dai
- Radiology Department, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Lei Wan
- Department of Cardiovascular Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Shuling Zhang
- Department of Respiratory Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hongxing Peng
- Department of Respiratory Medicine, Liyuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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