Kronik Obstrüktif Akciğer Hastalığı Alevlenmelerinde Pulmoner Arter/Aort Oranı ile Hastanede Yatış Süresi Arasındaki İlişki: Retrospektif Bir Kohort Analizi ve Klinik Çıkarımlar

Abstract

Amaç: Bu çalışma, kronik obstrüktif akciğer hastalığı (KOAH) akut alevlenmesi ile hastaneye yatırılan hastalarda pulmoner arter/aort (PA/Ao) oranı ile hastanede yatış süresi, hastalık şiddeti ve klinik sonuçlar arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır. Yöntemler: Mayıs 2022 ile Şubat 2024 tarihleri arasında KOAH alevlenmesi ile başvuran 214 hasta üzerinde retrospektif bir analiz gerçekleştirilmiştir. Kapsamlı dışlama kriterleri uygulandıktan sonra 160 hasta nihai analize dahil edilmiştir. PA/Ao oranları toraks bilgisayarlı tomografi görüntüleri üzerinden ölçülmüştür. Hastanede yatış süresi, yıllık alevlenme sıklığı ve klinik parametreler değerlendirilmiştir. İstatistiksel analizde logaritmik dönüşüm, çok değişkenli regresyon ve ROC analizi kullanılmıştır. Bulgular: Ortalama yaş 69,4±9,2 yıl olup hastaların %64,4'ü erkektir. Ortalama PA/Ao oranı 1,105±0,119 olarak saptanmıştır. PA/Ao oranı, logaritmik dönüşüm uygulanmış hastanede yatış süresi (β=1,4132, %95 GA: 0,739-2,088, p=0,0001) ve yıllık alevlenme sıklığı (r=0,296, p=0,0001) ile anlamlı pozitif korelasyon göstermiştir. PA/Ao >1,15 olan hastalarda anlamlı derecede daha uzun hastane yatış süresi (7,7±8,0'e karşı 4,7±3,2 gün, p=0,0025) ve daha yüksek yıllık alevlenme sıklığı (1,98±1,28'e karşı 1,39±0,76, p=0,0003) saptanmıştır. Çok değişkenli analizde PA/Ao oranı ve serum laktat düzeyi hastanede yatış süresinin bağımsız belirleyicileri olarak tanımlanmıştır (Model R²=0,247). Sonuç: PA/Ao oranı KOAH alevlenmelerinde hastanede yatış süresi ve hastalık şiddetinin güvenilir bir öngördürücüsüdür. Bu non-invaziv radyolojik parametre klinik risk sınıflandırması ve tedavi planlamasında kullanılabilir.

Keywords

• Kronik obstrüktif akciğer hastalığı
• PA/Ao oranı
• hastanede yatış süresi
• alevlenme sıklığı
• laktat

Relationship between pulmonary artery-to-aorta ratio and hospital length of stay in chronic obstructive pulmonary disease exacerbations: a retrospective cohort analysis and clinical implications

Abstract

Aims: This study aims to evaluate the relationship between pulmonary artery/aorta (PA/Ao) ratio and hospital length of stay, disease severity, and clinical outcomes in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A retrospective analysis was conducted on 214 patients admitted with COPD exacerbation between May 2022 and February 2024. Following comprehensive exclusion criteria, 160 patients were included in the final analysis. PA/Ao ratios were measured on thoracic computed tomography images. Hospital length of stay, annual exacerbation frequency, and clinical parameters were evaluated. Statistical analysis employed log-transformation, multivariable regression, and ROC analysis. Results: Mean age was 69.4±9.2 years, with 64.4% being male. Mean PA/Ao ratio was 1.105±0.119. PA/Ao ratio showed significant positive correlation with log-transformed hospital length of stay (β=1.4132, 95% CI: 0.739-2.088, p=0.0001) and annual exacerbation frequency (r=0.296, p=0.0001). Patients with PA/Ao>1.15 had significantly longer hospital stays (7.7±8.0 vs 4.7±3.2 days, p=0.0025) and higher annual exacerbation frequency (1.98±1.28 vs 1.39±0.76, p=0.0003). Multivariable analysis identified PA/Ao ratio and serum lactate level as independent predictors of hospital length of stay (Model R²=0.247). Conclusion: PA/Ao ratio is a reliable predictor of hospital length of stay and disease severity in COPD exacerbations. This non invasive radiological parameter can be utilized in clinical risk stratification and treatment planning.

Keywords

• Chronic obstructive pulmonary disease
• PA/Ao ratio
• hospital length of stay
• exacerbation frequency
• lactate

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