Baseline low ALT activity is associated with increased long-term mortality after COPD exacerbations

COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase)...

Full description

Saved in:

Bibliographic Details
Published in:	BMC pulmonary medicine Vol. 20; no. 1; p. 133
Main Authors:	Lasman, N, Shalom, M, Turpashvili, N, Goldhaber, G, Lifshitz, Y, Leibowitz, E, Berger, G, Saltzman-Shenhav, G, Brom, A, Cohen, D, Avaky, C, Segal, G
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 11-05-2020 BioMed Central BMC
Subjects:	Age Aged Aged, 80 and over Alanine Alanine aminotransferase Alanine Transaminase - blood ALT Biomarkers - blood Cardiovascular diseases Chronic illnesses Chronic obstructive lung disease Chronic obstructive pulmonary disease Clinical outcomes Complications and side effects COPD Creatinine Disease Disease Progression Exacerbation Female Frailty Frailty - enzymology Health aspects Hospitals Humans Israel Male Measurement Medical records Middle Aged Mortality Older people Patient outcomes Patients Physiological aspects Prognosis Prospective Studies Pulmonary Disease, Chronic Obstructive - enzymology Pulmonary Disease, Chronic Obstructive - mortality Pulmonology Rehabilitation Risk Factors Sarcopenia Sarcopenia - enzymology Software Statistical analysis Studies Survival Survival Analysis Israel Exacerbation Sarcopenia ALT Frailty Survival COPD
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival. This is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation. Included were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13-41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatic tissue damage (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11 IU; 12-16 IU; 17-20 IU and > 21 IU the mortality rates were 69%; 40.9%; 36.3 and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11 IU was 2.37 (95% CI; 1.6-3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08-3.1, p < 0.05). Low ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2466 1471-2466
DOI:	10.1186/s12890-020-1169-z