RT Journal Article SR Electronic T1 Clinical characteristics and determinants of exacerbation in Japanese patients with COPD: Hokkaido COPD cohort study results JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P4809 VO 40 IS Suppl 56 A1 Masaru Suzuki A1 Hironi Makita A1 Satoshi Konno A1 Kaoruko Shimizu A1 Natsuko Taniguchi A1 Yoichi M. Ito A1 Masaharu Nishimura YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/P4809.abstract AB Introduction: Exacerbations are one of the major factors that may influence natural history of COPD. However, little is known about clinical characteristics and determinants of exacerbation of COPD in a Japanese population. Aim: To examine characteristics and determinants of exacerbation in Japanese patients with COPD in a 5-year observational cohort study. Methods: A total of 279 patients with COPD participated in the Hokkaido COPD cohort study (AJRCCM 2012) and 268 subjects (GOLD 1, 26%; GOLD 2, 45%; GOLD 3, 24%; GOLD 4, 5%) who had clinical data of multiple visits were analyzed for this analysis. Exacerbation was defined in four ways: symptom criteria, requiring prescription change (prescription criteria), requiring antibiotics treatment (antibiotics criteria), and requiring hospital admission (admission criteria). Exacerbation frequency was observed over a period of 5 years. Results: Exacerbation event frequency was 0.24±0.47/yr (symptom criteria), 0.20±0.43/yr (prescription criteria), 0.13±0.28/yr (antibiotics criteria), and 0.06±0.19/yr (admission criteria). Cox proportional hazard model showed that an increase in SGRQ total score was significantly associated with short exacerbation-free period defined by all criteria and a decrease in body mass index (BMI) was also associated with short exacerbation-free period defined by antibiotics and admission criteria. Subjects who experienced hospital admission >1/yr tended to have rapid annual decline in FEV1 (p=0.07). Conclusion: While exacerbation frequency is low in our cohort subjects, poor health-related quality of life and low BMI are independent risk factors for the development of exacerbation of COPD.