RT Journal Article
SR Electronic
T1 Predictors of exacerbation frequency in chronic obstructive pulmonary disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4069
DO 10.1183/13993003.congress-2015.PA4069
VO 46
IS suppl 59
A1 Miguel Santibañez
A1 Roberto Garrastazu
A1 Juan Luis Garcia-Rivero
A1 Mario Ruiz
A1 Sandra Arenal
A1 Jose Helguera
A1 Cristina Bonnardeaux
A1 Carlos Leon
A1 Javier Llorca
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA4069.abstract
AB Background: Despite the importance of exacerbations of chronic obstructive pulmonary disease (COPD), we know little about their determinants.Objectives: To analyze whether there is a frequent-exacerbation phenotype independent of COPD severity, and the independent effect of COPD severity on the risk of exacerbations.Methods: Retrospective population-based cohort study. 900 patients with confirmed COPD ≥35 years, including non-smokers and mild stages, were selected by simple random sampling from all COPD patients in Cantabria-Spain at 31.12.2011. Exacerbation was defined as in the ECLIPSE study (Hurst JR. et al. N Engl J Med 2010:363:1128-38). We defined 'Frequent Exacerbations the Following Year (FEFY)' as ≥2 exacerbations in 2012. Severity of COPD was categorized according to GOLD stages 1-4. Odds Ratios (OR) were estimated by logistic regression adjusting for Age, Gender, Smoking, COPD severity and exacerbations.Results: The main predictor of FEFY, independent of COPD severity, was a history of frequent exacerbations the previous year. Severe exacerbations predicted better the risk of severe exacerbations: adjusted OR (ORa) 6.73; 95%CI 3.53-18.83, and overall exacerbations (moderate + severe) predicted better the overall risk of FEFY. COPD severity, was associated with a higher risk of FEFY: Crude OR GOLD Stage 4: 3.86; 95%CI 1.50–9.93. However, this association diminished after adjusting for frequency of exacerbations the previous year: ORa 2.08; 95%CI 0.75–5.82.Conclusions: Our results support a frequent-exacerbation phenotype independent of COPD severity. COPD severity was associated with a higher risk of exacerbations, but this effect would be dependent of the exacerbations the previous year.