Prognostic value of pulmonary immune prognostic index in elderly patients with acute COPD exacerbation and respiratory failure

Abstract:Objective To investigate the predictive value of pulmonary immune prognostic index(LIPI) combined with prognostic nutritional index(PNI) for the prognosis of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with respiratory failure. Methods Eighty elderly patients with AECOPD and respiratory failure admitted to our hospital from May 2022 to March 2024 were selected. The clinical data and prognosis of the patients were collected by the electronic medical record system, and then divided into poor prognosis group(n=23) and good prognosis group(n=57) according to the prognosis. Logistic regression analysis was performed to analyze the prognostic factors affecting elderly patients with AECOPD and respiratory failure, and ROC curve was used to analyze the predictive value of LIPI score and PNI value for the prognosis of elderly patients with AECOPD and respiratory failure. Results There were significant differences in age, PCT, D-D, APACHE Ⅱ score, PaO₂, PaCO₂, NLR, dNLR, LDH, LIPI score and PNI value between the poor prognosis group and the good prognosis group(t/U=5.112,71.976,172.521,49.174,16.649,3.353,5.748,22.729,3.256,29.207,7.159,P<0.001). Logistic regression analysis showed that APACHE Ⅱ score, LDH, LIPI score and PNI value were independent predictors of poor prognosis in elderly patients with AECOPD and respiratory failure(P<0.05). ROC curve showed that the AUC of LIPI score, PNI value and the two in predicting the prognosis of elderly patients with AECOPD and respiratory failure were 0.646, 0.756, 0.809(Z/P=15.025/<0.001、12.573/<0.001). Conclusion LIPI score and PNI value are important predictors of the prognosis of elderly patients with AECOPD and respiratory failure, which can effectively predict and evaluate the prognosis of patients.