Pulmonology

Longitudinal PROs predict readmission or death after COPD discharge (SREM best).

In a multicenter cohort of 344 hospitalized COPD patients followed up to 3 years, 111 (32.3%) experienced readmission or death. Time-varying PROs entered into three dynamic models showed the Shared Random-Effects Model (SREM) had the best discrimination and calibration. Each one‑unit higher PRO score was associated with a 4.3% lower hazard of adverse outcome (HR 0.957, 95% CI 0.933–0.980). Educational level and inflammatory markers (procalcitonin, CRP) were independently associated with outcomes, supporting multivariable risk models. 1

Multimorbidity and post-TB lung disease: evidence very uncertain; HIV and undernutrition signal.

This systematic review included 41 studies from LMICs but found none specifically analysing multimorbidity and PTLD. Meta-analysis showed lower odds of spirometry-defined PTLD with HIV (OR 0.68, 95% CI 0.52–0.89). Diabetes associations were inconsistent (pooled OR 1.65, 95% CI 0.96–2.84), while undernutrition increased odds (OR 1.99, 95% CI 1.02–3.87). Most studies had high risk of bias and the certainty of evidence for pooled associations was rated very low. 2

Young adults with severe asthma have worse healthcare use and inflammation.

In the UK Severe Asthma Registry (n=2812; 236 aged 16–25), young adults had the lowest adherence and highest fractional exhaled nitric oxide. This age group had the highest emergency department attendance, hospitalisation rates, and the second highest intubation rate. At first annual review they showed the smallest improvement in asthma control and more frequent anxiety/depression reports. Findings suggest age-specific evaluation and interventions for engagement and exacerbation prevention are warranted. 3