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array:24 [ "pii" => "S1579212921003785" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.10.004" "estado" => "S300" "fechaPublicacion" => "2021-12-01" "aid" => "2661" "copyright" => "SEPAR" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2021;57:774-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289620303999" "issn" => "03002896" "doi" => "10.1016/j.arbres.2020.10.016" "estado" => "S300" "fechaPublicacion" => "2021-12-01" "aid" => "2661" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2021;57:774-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "¿Debe incluirse la saturación basal de oxígeno en la estratificación de riesgo de la enfermedad pulmonar obstructiva crónica propuesta por GesEPOC?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "774" "paginaFinal" => "776" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Should Pulse Oximeter Saturations Be Included in the Risk Stratification for Chronic Obstructive Pulmonary Disease Proposed by GesEPOC?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3491 "Ancho" => 2500 "Tamanyo" => 270259 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Curvas de supervivencia según criterios de riesgo clásicos (modelo<span class="elsevierStyleHsp" style=""></span>1) o incluyendo la variable saturación periférica de oxígeno (modelo<span class="elsevierStyleHsp" style=""></span>2).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Marco Figueira Gonçalves, Rafael Golpe, Yolanda Ramallo, Ignacio García Talavera, David Dacal" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Juan Marco" "apellidos" => "Figueira Gonçalves" ] 1 => array:2 [ "nombre" => "Rafael" "apellidos" => "Golpe" ] 2 => array:2 [ "nombre" => "Yolanda" "apellidos" => "Ramallo" ] 3 => array:2 [ "nombre" => "Ignacio" "apellidos" => "García Talavera" ] 4 => array:2 [ "nombre" => "David" "apellidos" => "Dacal" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212921003785" "doi" => "10.1016/j.arbr.2021.10.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921003785?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620303999?idApp=UINPBA00003Z" "url" => "/03002896/0000005700000012/v2_202112040821/S0300289620303999/v2_202112040821/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S157921292100402X" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.10.017" "estado" => "S300" "fechaPublicacion" => "2021-12-01" "aid" => "2665" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2021;57:776-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Sleep Duration and Cutaneous Melanoma Aggressiveness. A Prospective Observational Study in 443 Patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "776" "paginaFinal" => "778" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Duración del sueño y agresividad del melanoma cutáneo. Un estudio observacional prospectivo con 443 pacientes" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1273 "Ancho" => 2508 "Tamanyo" => 204935 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Relationship between sleep duration and commonly used clinical markers of tumor aggressiveness in cutaneous melanoma. <span class="elsevierStyleItalic">p</span> values refer to sleep duration<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>h versus control group (sleep duration between 6 and 8<span class="elsevierStyleHsp" style=""></span>h). Results were adjusted for age, sex, apnea-hypopnea index, body mass index, presence of insomnia and intake of hypnotics. SL: Short sleep; LS: Long Sleep.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jose Daniel Gómez Olivas, Francisco Campos-Rodriguez, Eduardo Nagore, Luis Hernández, Valentin Cabriada, Jorge Abad, Olga Mediano, Esther Pastor, Eusebi Chiner, Manuel Sanchez de la Torre, Irene Cano, Maria Somoza, Alberto Garcia-Ortega, Grace Oscullo, Miguel Angel Martinez-García" "autores" => array:15 [ 0 => array:2 [ "nombre" => "Jose Daniel" "apellidos" => "Gómez Olivas" ] 1 => array:2 [ "nombre" => "Francisco" "apellidos" => "Campos-Rodriguez" ] 2 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Nagore" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Hernández" ] 4 => array:2 [ "nombre" => "Valentin" "apellidos" => "Cabriada" ] 5 => array:2 [ "nombre" => "Jorge" "apellidos" => "Abad" ] 6 => array:2 [ "nombre" => "Olga" "apellidos" => "Mediano" ] 7 => array:2 [ "nombre" => "Esther" "apellidos" => "Pastor" ] 8 => array:2 [ "nombre" => "Eusebi" "apellidos" => "Chiner" ] 9 => array:2 [ "nombre" => "Manuel Sanchez" "apellidos" => "de la Torre" ] 10 => array:2 [ "nombre" => "Irene" "apellidos" => "Cano" ] 11 => array:2 [ "nombre" => "Maria" "apellidos" => "Somoza" ] 12 => array:2 [ "nombre" => "Alberto" "apellidos" => "Garcia-Ortega" ] 13 => array:2 [ "nombre" => "Grace" "apellidos" => "Oscullo" ] 14 => array:2 [ "nombre" => "Miguel Angel" "apellidos" => "Martinez-García" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292100402X?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000012/v3_202201080532/S157921292100402X/v3_202201080532/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1579212921004031" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.10.018" "estado" => "S300" "fechaPublicacion" => "2021-12-01" "aid" => "2660" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2021;57:772-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Transbronchial Cryobiopsy of Peripheral Pulmonary Lesions Guided With Real-Time Transthoracic Ultrasonography" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "772" "paginaFinal" => "774" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Criobiopsia transbronquial de lesiones pulmonares periféricas guiada en tiempo real con ultrasonografía transtorácica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 829 "Ancho" => 1255 "Tamanyo" => 135650 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Chest CT image shows a lingular mass with pleural contact and bronchus sign. (B) Flexible cryoprobe indicated for transbronchial biopsy. Outer diameter 1.9<span class="elsevierStyleHsp" style=""></span>mm, length 900<span class="elsevierStyleHsp" style=""></span>mm. (C) Transthoracic ultrasound image before performing transbronchial biopsy of the mass. (D) Transthoracic ultrasound image during the performance of transbronchial biopsy, which locates the cryoprobe within the lung mass (arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Felipe Andreo García, Mohamed Torky, Carmen Centeno Clemente, Pere Serra Mitjà, Antoni Rosell Gratacós, Rachid Tazi Mezalek" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Felipe" "apellidos" => "Andreo García" ] 1 => array:2 [ "nombre" => "Mohamed" "apellidos" => "Torky" ] 2 => array:2 [ "nombre" => "Carmen" "apellidos" => "Centeno Clemente" ] 3 => array:2 [ "nombre" => "Pere" "apellidos" => "Serra Mitjà" ] 4 => array:2 [ "nombre" => "Antoni" "apellidos" => "Rosell Gratacós" ] 5 => array:2 [ "nombre" => "Rachid" "apellidos" => "Tazi Mezalek" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921004031?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000012/v3_202201080532/S1579212921004031/v3_202201080532/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Should pulse oximeter saturations be included in the risk stratification for chronic obstructive pulmonary disease proposed by GesEPOC?" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "774" "paginaFinal" => "776" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Juan Marco Figueira Gonçalves, Rafael Golpe, Yolanda Ramallo, Ignacio García Talavera, David Dacal" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Juan Marco" "apellidos" => "Figueira Gonçalves" "email" => array:1 [ 0 => "juanmarcofigueira@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Rafael" "apellidos" => "Golpe" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Yolanda" "apellidos" => "Ramallo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "Ignacio" "apellidos" => "García Talavera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "David" "apellidos" => "Dacal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Grupo C039 Biodiscovery HULA-USC, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, La Coruña, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Santa Cruz de Tenerife, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Debe incluirse la Saturación basal de oxígeno en la estratificación de riesgo de la enfermedad pulmonar obstructiva crónica propuesta por GesEPOC?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3491 "Ancho" => 2500 "Tamanyo" => 269353 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Survival curves according to conventional risk criteria (model 1) or with the inclusion of peripheral oxygen saturation (model 2).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The 2017 edition of the Spanish Chronic Obstructive Pulmonary Disease Guidelines (GesEPOC) establishes a treatment algorithm based on the stratification of patient risk at 2 levels, low risk and high risk, according to three criteria: lung function, dyspnea grade, and history of exacerbations<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. This stratification was initially based on a theoretical framework designed to determine the probability of the patient presenting an unfavorable clinical course. Since the publication of the algorithm, several studies have evaluated its prognostic capacity and endorsed its usefulness in this respect<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Chronic respiratory failure is associated with a higher mortality rate in patients with chronic obstructive pulmonary disease (COPD)<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>. Peripheral oxygen saturation (SpO2) is easy to determine by pulse oximetry, and values <92% correlate with the presence of severe hypoxemia<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a>. On this premise, we conducted a retrospective study of patients with stable COPD monitored in a pulmonology clinic to analyze whether including the SpO2 measurement in the conventional GesEPOC risk criteria would improve the prognostic capacity of the algorithm. Consecutive patients with a diagnosis of COPD<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and a history of smoking (cumulative consumption >10 pack-years) were included. The following variables obtained at the first visit were recorded: lung function, body mass index (BMI), mMRC dyspnea grade, resting SpO2 (determined by the physician in clinically stable patients, breathing room air, at rest, and prior to physical examination), and history of exacerbations prior to inclusion, taking into account both moderate (requiring outpatient treatment with antibiotics and/or steroids) and severe (requiring emergency or hospital admission) exacerbations. Patients were classified as high risk and low risk according to the current GesEPOC criteria<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> (in the presence of any of the following criteria the patient would be categorized as high risk: FEV1% <50%, dyspnea ≥2 if treated, 2 or more moderate exacerbations or ≥ 1 severe exacerbations the previous year), and this was compared with a classification in which high-risk patients were categorized as SpO2 <92% (high risk-SpO2 <92%) and SpO2 ≥92% (high risk-SpO2 ≥92%). A Cox regression survival analysis was performed to compare the two classifications: model 1 was obtained with the conventional GesEPOC classification; and model 2 included the variable SpO2 in the classification. The models were adjusted for age and comorbidity measured with the unadjusted Charlson index. The Akaike information criterion (AIC) was obtained for model comparison. Adjusted survival curves were obtained. Data collection was approved by the Santiago-Lugo Research Ethics Committee.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Overall, 710 patients were included, of whom 632 were men (89%), with a mean age of 68.3 ± 9.6 years, post-bronchodilator FEV1% 50.5 ± 17.2, and BMI 28.3 ± 5.2 kg/m<span class="elsevierStyleSup">2</span>. One quarter (25.9%) were active smokers and the pack-year index was 59.3 ± 30.7. The Charlson comorbidities index was 1.98 ± 1.41. In total, 522 patients were classified as high risk (73.5%) and 188 (26.5%) as low risk. The mean SpO2 was 93.1 ± 4.6%. One hundred and sixty-four (23.1%) had SpO2 <92%, of which 155 were high risk. Mean follow-up time was 53.9 ± 26.7 months.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Overall mortality during follow-up was 25.8%, with significant differences between the low-risk group and the high risk group (10.1% vs 31.5%: <span class="elsevierStyleItalic">P</span> < .0001, respectively). The high risk-SpO2 group <92% had a mortality rate of 54.2%, compared with 21.9% in the high risk-SpO2 group ≥92% (<span class="elsevierStyleItalic">P</span> < .0001). In the Cox regression analysis, compared to the low-risk group, high-risk patients with SpO2 <92% have a greater risk of mortality (HR: 4.79; 95% CI: 2.90−7.91; <span class="elsevierStyleItalic">P</span> < .001) than high-risk patients with SpO2 ≥92 (HR: 1.7; 95% CI: 1.02−2.80; <span class="elsevierStyleItalic">P</span> < .001) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>; model 2) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">In our study, the addition of the SpO2 variable to the conventional GesEPOC criteria improves its prognostic capacity and classifies patients more precisely in terms of their mortality risk.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Factors, such as impaired ventilation-perfusion, dysregulation of respiratory center drive, or inspiratory muscle dysfunction due to pulmonary hyperinflation, contribute to the development of hypoxemia in COPD patients, impacting negatively on their life expectancy<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8–11</span></a>. A cut-off point of SpO2 ≥92% is highly sensitive for ruling out respiratory failure, while SpO2 ≤88% is highly specific for confirming it<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a>. Taking a pragmatic approach, and to avoid excluding any patient with respiratory failure, we selected a value of SpO2 <92%<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. Thus, not all patients would meet the criteria for initiating long-term oxygen therapy (LTOT), so an intense bronchodilator therapy, sustained smoking abstention, and early onset of respiratory rehabilitation would hypothetically improve baseline SpO2 values<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12–15</span></a> and consequently, life expectancy. In line with the concept of personalized treatment proposed by GesEPOC, our approach may of particular interest in high-risk individuals with SpO2 <92% in whom the recommended initiation therapy would be a long-acting β2-agonist inhaled corticosteroid, as would correspond to the COPD-asthma phenotype. These subjects may benefit from early initiation of dual bronchodilation, despite the clinical impact that could be achieved with an inhaled corticosteroid. Furthermore, although this was not an objective of the study, we must point out that 9 patients in the low-risk group had SpO2 <92%. While this accounted for a very low percentage of patients, we believe that further studies that characterize these individuals in more depth may be needed to assess the clinical relevance of this finding.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our study has limitations and essentially serves to generate debate. It is a retrospective study, conducted in a single center. The number of low-risk patients was very low, as SpO2 could not be used as a variable in these subjects. We cannot rule out that many of these patients were prescribed LTOT during follow-up, which could have influenced the reported mortality figures. Patients could not be stratified according to SpO2 ranges to avoid reducing statistical power. Despite these limitations, we believe that our results could be a stimulus for carefully designed studies that assess the inclusion of SpO2 in the conventional criteria for high-risk patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">No funding was received for this manuscript.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interests directly or indirectly related with the contents of this manuscript.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Figueira Gonçalves JM, Golpe R, Ramallo Y, García Talavera I, Dacal D. ¿Debe incluirse la Saturación basal de oxígeno en la estratificación de riesgo de la enfermedad pulmonar obstructiva crónica propuesta por GesEPOC? Arch Bronconeumol. 2021;57:774–776.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3491 "Ancho" => 2500 "Tamanyo" => 269353 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Survival curves according to conventional risk criteria (model 1) or with the inclusion of peripheral oxygen saturation (model 2).</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">95% CI: 95% confidence interval; SpO2: peripheral oxygen saturation determined by pulse oximetry. Model 1 was analyzed using the conventional GesEPOC classification of high and low risk. In model 2, high-risk patients were classified according to their SpO2 value. Both models were adjusted for age and Charlson comorbidity index. The AIC for model 1 is 2,194.44 and for model 2, it is 2,063.95.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 1</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 2</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Classification according to conventional GesEPOC criteria</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Low risk (reference) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.53 (1.57−4.08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Classification according to conventional GesEPOC criteria + SpO2</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Low risk (reference) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High risk + SpO2 ≥92% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 (1.02−2.80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High risk + SpO2 <92% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.79 (2.90−7.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Charlson comorbidity index</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.31 (1.21−1.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.31 (1.21−1.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.04 (1.2−1.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.04 (1.02−1.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2798306.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Results of logistic regression analysis based on the conventional GesEPOC classification (model 1) or with the inclusion of peripheral oxygen saturation (model 2).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía española de la enfermedad pulmonar obstructiva crónica (GesEPOC) 2017. 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Year/Month | Html | Total | |
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2024 November | 6 | 1 | 7 |
2024 October | 74 | 24 | 98 |
2024 September | 92 | 12 | 104 |
2024 August | 100 | 32 | 132 |
2024 July | 97 | 11 | 108 |
2024 June | 99 | 19 | 118 |
2024 May | 102 | 21 | 123 |
2024 April | 58 | 16 | 74 |
2024 March | 60 | 11 | 71 |
2024 February | 53 | 24 | 77 |
2024 January | 52 | 26 | 78 |
2023 December | 39 | 29 | 68 |
2023 November | 38 | 18 | 56 |
2023 October | 48 | 36 | 84 |
2023 September | 30 | 24 | 54 |
2023 August | 31 | 30 | 61 |
2023 July | 31 | 20 | 51 |
2023 June | 30 | 9 | 39 |
2023 May | 41 | 20 | 61 |
2023 April | 40 | 22 | 62 |
2023 March | 51 | 21 | 72 |
2023 February | 30 | 14 | 44 |
2023 January | 35 | 27 | 62 |
2022 December | 64 | 31 | 95 |
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