Background & Aims: Chronic obstructive pulmonary disease (COPD) is considered as a systemic disease by chronic inflammation with exacerbation episodes. Fibrinogen is a marker of systemic inflammation. The aim of this study was to assess the relation between plasma of fibrinogen level with adverse outcome in COPD patients.

Materials & Methods: In this cohort study patients with acute exacerbation of COPD admitted to pulmonary ward were studied prospectively.  They were divided into two cohort, patients with high plasma fibrinogen (>400 mg/dl) and less than 400 mg/dl on admission day venous blood. The patients were followed for duration of hospitalization and any adverse outcome (death in the hospital, transfer to ICU, intubation and mechanical ventilation). Relation of fibrinogen level with outcome evaluated.

Results : Among 54 patients, 15 had adverse outcome, and 39 good outcomes. Among these two groups, the  mean plasma fibrinogen was 530±256.43 mg/L and 155.67±96.55, respectively (p=0.001). In 14 patients plasma fibrinogen level was >400 mg/dl and in 40 patients ≤ 400 mg/dl 

The rate of adverse outcome was 85.7%  in 7.5% in those with higher and lower fibrinogen level  (p value=0.001). The mean duration of hospitalization was 13.7±5.27 vs. 5.02± 2.06 days in fibrinogen > 400 mg/dl and  ≤ 400 mg/dl group respectively (p value=0.001)

Conclusion: Plasma fibrinogen obtained at admission day may assist identification of high-risk patients with acute exacerbation of COPD.

SOURCE: URMIA MED J 2013: 24(2): 103 ISSN: 1027-3727