med j west black sea Medical Journal of Western Black Sea 2822-4302 2587-0602 Zonguldak Bulent Ecevit University 10.29058/mjwbs.1027675 Health Care Administration Sağlık Kurumları Yönetimi Are Uric Acid and Uric Acid Creatinine Ratio Predictors for Mortality in Acute Exacerbations of Chronic Obstructive Pulmonary Disease? Kronik Obstrüktif Akciğer Hastalığının Akut Alevlenmesinde Ürik Asit ve Ürik Asitin Kreatinine Oranı Mortalitenin Öngörücüleri midir? https://orcid.org/0000-0003-4041-7479 Abalı Hülya Sağlık Bilimleri Üniversitesi YGHH EAH https://orcid.org/0000-0002-0657-0392 Tural Önür Seda UNIVERSITY OF HEALTH SCIENCES, İSTANBUL YEDİKULE HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY, DEPARTMENT OF INTERNAL MEDICINE https://orcid.org/0000-0002-3793-9834 Tokgöz Akyıl Fatma UNIVERSITY OF HEALTH SCIENCES, İSTANBUL YEDİKULE HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY, DEPARTMENT OF INTERNAL MEDICINE https://orcid.org/0000-0002-7184-2075 Sökücü Sinem Nedime UNIVERSITY OF HEALTH SCIENCES, İSTANBUL YEDİKULE HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY, DEPARTMENT OF INTERNAL MEDICINE https://orcid.org/0000-0002-7430-837X Demir Dilara ÜSKÜDAR ÜNİVERSİTESİ https://orcid.org/0000-0002-5917-2574 Boyracı Neslihan UNIVERSITY OF HEALTH SCIENCES, İSTANBUL YEDİKULE HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY, DEPARTMENT OF INTERNAL MEDICINE 08 31 2022 6 2 142 149 11 24 2021 05 26 2022 Copyright © 2017, Medical Journal of Western Black Sea 2017 Medical Journal of Western Black Sea

Amaç: Kronik Obstrüktif Akciğer Hastalığı (KOAH) klinik seyrinde, kötü prognoza neden olan, ektedavi gerektiren, solunum semptomlarında (dispne, öksürük, balgam) kötüleşme olarak tanımlananalevlenmeler gözlenebilir. Maliyet-etkin mortalite öngörücüleri, KOAH’ın tedavi yönetimi için değerlidir.Akut KOAH alevlenmeleri olan serum ürik asit (ÜA) ve serum ürik asitin kreatinine oranının (ÜKO) mortalite ve hipoksemi için belirleyici olupolmadığını araştırmayı amaçladık.Gereç ve Yöntemler: Bu gözlemsel kesitsel çalışmada, Ocak 2014 ile Aralık 2018 arasında bir referans göğüs hastanesinde yatan 105KOAH alevlenmesindeki hasta retrospektif olarak değerlendirildi. ÜA ve ÜKO ile uzun vadeli mortalite, hipoksemi, komorbidite, FEV1 değeri,KOAH’ın tanı, tedavi ve önlenmesi için küresel strateji (GOLD) evreleri arasındaki ilişkiler analiz edildi.Bulgular: KOAH alevlenmesindeki toplam 105 hastayı (97’si erkek, ortalama yaş 65±9 yıl) içeren bu çalışmada hiperürisemi ile mortalitearasında anlamlı bir korelasyon bulunurken (sırasıyla, p=0.027; p=0.016), ÜKO ile mortalite arasında korelasyon bulunmadı (sırasıyla,p=0.051, p=0.053). Düşük ÜA seviyesi hipoksemi ile anlamlı olarak ilişkiliydi (p=0.022), ancak ÜKO ile hipoksemi arasında bir ilişki gözlenmedi(p=0.094).Sonuç: KOAH alevlenmesindeki hastaların uzun vadeli mortalitesini öngörmede serum ÜA’nin ÜKO’na göre daha değerli olduğugörülmektedir. Sık klinik takip ve yoğun tedavi yönetimi gerektiren yüksek riskli KOAH hastalarının tanımlanması için serum ÜA’in uzunvadeli mortalitenin biyobelirteci olarak kullanılabileceğini öneriyoruz.

Aim: In the clinical course of Chronic Obstructive Pulmonary Disease (COPD), exacerbations thatare defined as worsening of respiratory symptoms (dyspnoea, cough, sputum production) may occur,which causes poor prognosis and require additional treatments. Cost-effective mortality predictors arevaluable for the treatment management of COPD. We aimed to investigate whether serum uric acid(UA) and serum uric acid to creatinine ratio (UCR) are predictors of mortality and hypoxemia in patientswith acute exacerbations of COPD (AECOPD).Material and Methods: 105 patients with AECOPD who were hospitalized in a reference chest hospitalbetween January 2014 and December 2018 were evaluated retrospectively in this cross-sectional study.The associations between UA and UCR and long-term mortality, hypoxemia, comorbidity, FEV1 value,and Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive PulmonaryDisease (GOLD) stage were analyzed.Results: In the present study including 105 patients with AECOPD (97 males, mean age of 65±9 years),a significant correlation was found between hyperuricemia and mortality (95% CI:1.15-10.72, p=0.027;95% CI:1.16-4.12, p=0.016, respectively), while no correlation was found between UCR and mortality(p=0.051, p=0.053, respectively). Low UA level was associated with hypoxemia significantly (p=0.022),but no association was observed between UCR and hypoxemia (p=0.094).Conclusion: It appears that UA is more important for predicting long-term mortality in patients withAECOPD than UCR. We suggest that UA can be used as a biomarker of long-term mortality for theidentification of high-risk COPD patients that require frequent clinical follow-up and intense treatmentmanagement.

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