The Clinical Characteristics of Intestinal Flora Imbalance in Stable Chronic Obstructive Pulmonary Disease (COPD) and Construction of Early Warning Model

Bcackground There is still a lack of predictive models for early identification of intestinal flora imbalance in stable Chronic Obstructive Pulmonary Disease (COPD) patients. We assessed the risk factors related to intestinal flora imbalance in COPD patients, and established a simple predictive model and scoring rules suitable for clinical medical staff in the respiratory department.Methods From January 1, 2018 to December 31, 2019, COPD patients (195 cases), who attended the Outpatient Department of Respiratory and Critical Care of Yixing Hospital of Jiangsu University, were collected for a cross-sectional study. The patients were divided into the experimental groups (41 cases) and the control group (154 cases) based on the results of stool examination. By single-factor analysis and logistic regression analysis, the baseline data of two groups were performed to obtain a new prediction model, and then simplified it.Results The five predictive factors including body mass index(BMI), serum albumin(ALB), charlson comorbidity index(CCI), gastrointestinal symptom score(GSRs), and Global Initiative for Chronic Obstructive Lung Disease(GOLD) classification entered the model. The area under the ROC curve of the model for predicting intestinal flora imbalance in patients with stable COPD is 0.953 [95%CI (0.924, 0.982)], further simplifying the scoring rules, and the area under the ROC curve is 0.767 [95%CI (0.676, 0.858)]. Conclusions In the study, the prediction model can scientifically and effectively predict the risk of intestinal flora imbalance in patients with stable COPD, and then implement early treatment to improve the prognosis. Furthermore, all indicators can be obtained easily and simply.