Risk Factors Analysis Of AECOPD Patients With PTE And Prediction Model Construction

Objective:To retrospectively collect the clinical data of patients with Acute Exacerbation of Chronic obstructive pulmonary disease（AECOPD）and AECOPD complicated with pulmonary thromboembolism（PTE）from August 2019 to August2021 in our hospital,analyze the risk factors of AECOPD patients complicated with PTE,and establish a risk prediction model,so as to provide reference for clinicians to screen and identify AECOPD complicated with PTE in early stage.Methods:1.The data of 118 patients with AECOPD who were treated in Xiangxi Autonomous Prefecture People’s Hospital from August 2019 to August 2021 and improved CT pulmonary angiography（CTPA）were collected.According to the inclusion and exclusion criteria,58 patients with AECOPD combined with PTE and60 patients with AECOPD alone were screened out.2.The difference of clinical data and measurement data between AECOPD combined with PTE group and AECOPD group were analyzed,and two independent samples t-test was selected to meet the variance homogeneity.Mann-Whitney U test was selected for variance,Chi-square（X2）test or Fisher exact probability method was used for counting data,and statistically significant factors were screened out（P<0.05）.Multivariate Logistic regression analysis was used for screening independent risk factors.According to the results of multivariate Logistic regression analysis,a line chart prediction model was established,which was verified by C-index and correction curve.Results:1.The results of univariate analysis showed that PaO₂,BNP,D-dimer,leukocyte,neutrophil,erythrocyte distribution width,fibrinogen were significantly different between AECOPD group with PTE and AECOPD group（P<0.05）.2.Multivariate Logistic regression analysis showed that neutrophils（OR=1.243,95%CI:1.06-1.47,P<0.05）,erythrocyte distribution width（OR=1.183,95%CI:1.02-1.38,P<0.05）,fibrinogen（OR=1.518,95%CI:1.04-2.23,P<0.05）,PaO₂（OR=0.954,95%CI:0.93-0.98,P<0.05）were the risk factors for PTE in AECOPD patients,and PaO₂ was its protective factor.3.Based on the results of multi-factor Logistic regression analysis,the prediction model was established,the C index was 0.787,the prediction ability was good,the correction curve had good fitting degree,and the model had good stability.Conclusion:1.The decrease of PaO₂,the increase of neutrophil,red blood cell distribution width and fibrinogen level are the independent risk factors of PTE in AECOPD patients.2.The prediction model of AECOPD combined with PTE in this study has good prediction ability.