J Montserrat-Capdevila1, P Godoy2, J R Marsal3, F Barbé4, L Galván5. 1. Epidemiologia Aplicada, Institut de Recerca Biomèdica de Lleida, calle Alcalde Rovira Roure 2, Lleida 25006, Spain. jmontser@alumni.unav.es. 2. Biomedical Research Institute (IRB) of Lleida, Lleida, Spain; Health Department, Public Health Agency of Catalonia, Lleida, Spain; and Faculty of Medicine, University of Lleida, Lleida, Spain. 3. Lleida Research Support Unit, Primary Care Research Institute (IDIAP), Jordi Gol, Autonomous University of Barcelona, Lleida, Spain; Cardiovascular Department, Epidemiology Unit, University Hospital Vall d'Hebron, Barcelona, Spain. 4. Biomedical Research Institute (IRB) of Lleida, Lleida, Spain; Health Department, Public Health Agency of Catalonia, Lleida, Spain; Faculty of Medicine, University of Lleida, Lleida, Spain; Pneumology Unit, University Hospital Arnau de Vilanova, Lleida, Spain; and Biomedical Research Centre Network for Respiratory Diseases (CIBERES), Madrid, Spain. 5. Pharmacy Unit, Catalan Health Service, Lleida, Spain.
Abstract
BACKGROUND: Although acute exacerbations are key events in the progression of chronic obstructive pulmonary disease (COPD), their frequency and the factors associated with acute exacerbation are not fully known. OBJECTIVE: To determine the incidence and risk factors of very frequent exacerbations in COPD (⩾3 per year). PATIENTS AND METHODS: In a cohort study to analyse acute exacerbation and associated factors in 512 primary care patients during a 2-year follow-up, variables of interest were collected for each patient. Acute exacerbation was defined as an event that required antibiotics and/or systemic steroids (moderate) or hospital admission (severe). Odds ratios (OR) were used to determine factors associated with exacerbation. RESULTS: Incidence of exacerbation was 61.7% in the first year of follow-up and 63.9% in the second year. During the first year, the factors associated with very frequent exacerbation were previous hospital admission (OR 1.69), dyspnoea (moderate [OR 2.86] and severe-very severe [OR 5.83]) and the Charlson Index (OR 1.19); during the second year, associated factors were female sex (OR 4.17), history of previous hospital admissions (OR 2.90), smoking (smoker/ex-smoker) (OR 2.00) and forced vital capacity (OR 0.98). CONCLUSIONS: Incidence of exacerbation is high in COPD patients. Previous admission for exacerbation is a strong predictor and can identify patients at risk.
BACKGROUND: Although acute exacerbations are key events in the progression of chronic obstructive pulmonary disease (COPD), their frequency and the factors associated with acute exacerbation are not fully known. OBJECTIVE: To determine the incidence and risk factors of very frequent exacerbations in COPD (⩾3 per year). PATIENTS AND METHODS: In a cohort study to analyse acute exacerbation and associated factors in 512 primary care patients during a 2-year follow-up, variables of interest were collected for each patient. Acute exacerbation was defined as an event that required antibiotics and/or systemic steroids (moderate) or hospital admission (severe). Odds ratios (OR) were used to determine factors associated with exacerbation. RESULTS: Incidence of exacerbation was 61.7% in the first year of follow-up and 63.9% in the second year. During the first year, the factors associated with very frequent exacerbation were previous hospital admission (OR 1.69), dyspnoea (moderate [OR 2.86] and severe-very severe [OR 5.83]) and the Charlson Index (OR 1.19); during the second year, associated factors were female sex (OR 4.17), history of previous hospital admissions (OR 2.90), smoking (smoker/ex-smoker) (OR 2.00) and forced vital capacity (OR 0.98). CONCLUSIONS: Incidence of exacerbation is high in COPDpatients. Previous admission for exacerbation is a strong predictor and can identify patients at risk.
Authors: Sukrit S Jain; Indra Neil Sarkar; Paul C Stey; Rajsavi S Anand; Dustin R Biron; Elizabeth S Chen Journal: AMIA Annu Symp Proc Date: 2018-12-05
Authors: Christopher J Stewart; Thomas A Auchtung; Nadim J Ajami; Kenia Velasquez; Daniel P Smith; Richard De La Garza; Ramiro Salas; Joseph F Petrosino Journal: PeerJ Date: 2018-04-30 Impact factor: 2.984
Authors: Christina Hoffmann; Marc Hanisch; Jana B Heinsohn; Vanessa Dostal; Melissa Jehn; Uta Liebers; Wulf Pankow; Gavin C Donaldson; Christian Witt Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-10-23
Authors: Anthony C A Yii; C H Loh; P Y Tiew; Huiying Xu; Aza A M Taha; Jansen Koh; Jessica Tan; Therese S Lapperre; Antonio Anzueto; Augustine K H Tee Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-03-27