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Hepatic Fibrosis Assessed Using Fibrosis-4 Index Is Predictive of All-Cause Mortality in Patients With Chronic Obstructive Pulmonary Disease

Authors
 Seung Hyun Yong  ;  Ah Young Leem  ;  Young Sam Kim  ;  Moo Suk Park  ;  Joon Chang  ;  Seung Up Kim  ;  Ji Ye Jung 
Citation
 INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, Vol.15 : 831-839, 2020-04 
Journal Title
 INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE 
ISSN
 1176-9106 
Issue Date
2020-04
Keywords
FIB-4 ; chronic obstructive pulmonary disease ; exacerbation ; liver fibrosis ; mortality
Abstract
Background: Various comorbidities influence the prognosis of patients with chronic obstructive pulmonary disease (COPD). We investigated if liver fibrosis assessed using fibrosis-4 index (FIB-4) is associated with all-cause mortality in patients with COPD. Methods: We included 756 patients diagnosed with COPD between 2006 and 2010. Medical records were retrospectively reviewed until 2018. FIB-4 was calculated using the following equation: [age (years) × aspartate aminotransferase (IU/L)/(platelet count (109/L) × √alanine aminotransferase (IU/L))]. Results: From a total of 756 patients, 582 (76.9%) patients were categorized into survivor and 174 (23.1%) into non-survivor groups. The non-survivor group was significantly older with a higher proportion of male, smoker and lower FEV1/FVC ratio than the survivor group (all P<0.05). Various comorbidities were more frequently observed in the non-survivor group (P<0.05). In addition, the non-survivor group had significantly higher FIB-4 than the survivor group (1.8 vs 1.4, P<0.001). In multivariate analysis, older age (hazard ratio [HR]=1.05), underlying malignancy (HR=2.94), coronary artery occlusive disease (HR=1.58), higher FIB-4 (HR=1.15), and higher GOLD stage (HR=1.26) were significantly associated with the increased risk of all-cause mortality (P<0.05), whereas body mass index (HR=0.95) was independently protective for all-cause mortality (all P<0.05). The high FIB-4 (>1.57) group showed a significantly lower cumulative survival rate than the low FIB-4 (≤1.05) group (P=0.031, Log-rank test). In multivariate regression analysis, higher FIB-4 independently predicted the risk of acute exacerbation (odds ratio=1.08, P=0.034). Conclusion: Higher fibrotic burden assessed using FIB-4 was independently predictive of the increased risk of all-cause mortality and acute exacerbation in patients with COPD.
Files in This Item:
T202001606.pdf Download
DOI
10.2147/COPD.S242863
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176197
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