Yu BY, Wang H, Lin YY. Prevalence and risk factors of upper gastrointestinal bleeding in chronic obstructive pulmonary disease patients.
Shijie Huaren Xiaohua Zazhi 2023;
31:143-149. [DOI:
10.11569/wcjd.v31.i4.143]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND
Chronic obstructive pulmonary disease (COPD) can cause upper gastrointestinal bleeding. In this study we identified the risk factors for upper gastrointestinal bleeding in patients with COPD by logistic regression analysis and established a logistic regression equation to predict the probability of upper gastrointestinal bleeding in COPD patients.
AIM
To investigate the prevalence and risk factors of upper gastrointestinal bleeding in patients with COPD.
METHODS
A total of 400 COPD patients treated at our hospital from October 2016 to October 2021 were selected, of which 240 were used for modeling. The prevalence of upper gastrointestinal bleeding in the modeling group was counted, the clinical data of patients with and without upper gastrointestinal bleeding were compared, and the factors influencing the occurrence of upper gastrointestinal bleeding were identified by logistic regression analysis. The rest 160 cases were included in a validation group to verify the performance of the logistic regression model developed.
RESULTS
Among the 240 COPD patients in the modeling group, the prevalence of upper gastrointestinal bleeding was 19.58% (47/240). The proportions of patients with coronary heart disease, severe infection, pulmonary encephalopathy, low ALB, and Helicobacter pylori infection were significantly higher in patients with upper gastrointestinal bleeding than in those without (P < 0.05). Age ≥ 60 years, COPD grade III, disease duration ≥ 4.3 years, gastritis, peptic ulcer, coronary heart disease, severe infection, pulmonary encephalopathy, and Helicobacter pylori infection were identified to be independent risk factors for upper gastrointestinal bleeding in COPD patients, while ALB elevation was a protective factor (P < 0.05). The area under the curve (AUC) of the logistic regression prediction model for predicting upper gastrointestinal bleeding in COPD patients was 0.867 (95% confidence interval [CI]: 0.818-0.907), with a sensitivity of 85.11% and specificity of 75.13%. When the logistic regression prediction model was applied to the validation group (160 COPD patients), the Hosmer-Lemeshow χ2 value was 3.142 (P = 0.514) and the AUC was 0.900 (95%CI: 0.855-0.935), suggesting good discriminant validity and calibration of the model.
CONCLUSION
The prevalence of upper gastrointestinal bleeding in COPD patients is relatively high, and its occurrence is related to many factors such as patient age, COPD severity and course, gastritis, peptic ulcer, coronary heart disease, severe infection, pulmonary encephalopathy, Helicobacter pylori infection, and elevated ALB. The logistic regression prediction model developed has good discriminant validity and calibration for predicting the risk of upper gastrointestinal bleeding in COPD patients.
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