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. 2024 Mar 12:2024:6038771.
doi: 10.1155/2024/6038771. eCollection 2024.

Use of the Serum Level of Cholinesterase as a Prognostic Marker of Nonfatal Clinical Outcomes in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Zhixiang Chen  1 , Lei Zha  2 , Bin Hu  1 , Bin Xu  1 , Lin Zuo  1 , Jun Yang  1 , Zhuhua Chu  1 , Lingling Ma  1 , Fangfang Hu  1
Affiliations

Use of the Serum Level of Cholinesterase as a Prognostic Marker of Nonfatal Clinical Outcomes in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Zhixiang Chen et al. Can Respir J. .

Abstract

Introduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes to a poor prognosis. Reliable biomarkers to predict adverse outcomes during hospitalization are important.

Aim: To investigate the relationship between the serum cholinesterase (ChE) level and adverse clinical outcomes, including hypoxemia severity, hypercapnia, duration of hospital stay (DoHS), and noninvasive ventilation (NIV) requirement, in patients with AECOPD.

Methods: Patients hospitalized with AECOPD in the Wuhu Hospital of Traditional Chinese Medicine between January 2017 and December 2021 were included.

Results: A total of 429 patients were enrolled. The serum ChE level was significantly lower in patients with hypercapnia, who required NIV during hospitalization and who had a DoHS of >10 days, with an oxygenation index < 300. The ChE level was correlated negatively with the C-reactive protein level and neutrophil-to-lymphocyte ratio and correlated positively with the serum albumin level. Multivariate logistic regression analysis indicated that a serum ChE level of ≤4116 U/L (OR = 2.857, 95% CI = 1.46-5.58, p = 0.002) was associated significantly with NIV requirement.

Conclusions: The serum ChE level was correlated significantly with complicating severe hypoxemia, hypercapnia, prolonged DoHS, and the need for NIV in patients hospitalized with AECOPD. The serum ChE level is a clinically important risk-stratification biomarker in patients hospitalized with AECOPD.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of our study.
Figure 2
Figure 2
Correlation between the serum ChE level and the NLR level (a), the CRP level (b), and the albumin level (c) in hospitalized patients with AECOPD. ChE: cholinesterase, NLR: neutrophil-to-lymphocyte ratio, CRP: C-reactive protein, and ALB: albumin.
Figure 3
Figure 3
Correlation of the serum ChE level with hypercapnia (a), NIV requirement (b), hypoxemia severity (c), duration of hospital stay (d) and PH (e). ChE: cholinesterase, pCO2: partial pressure of carbon dioxide, NIV: noninvasive ventilation, OI: oxygenation index, and DoHS: duration of hospital stay.
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