Abstract
Exacerbations are among the major factors that may affect the natural history of chronic obstructive pulmonary disease (COPD). The aim was to investigate the clinical characteristics and determinants of COPD exacerbations in our 5-year observational cohort study which had a very low exacerbation frequency.
A total of 279 patients with COPD participated in the Hokkaido COPD cohort study, and 268 subjects who had clinical data for multiple visits were analysed. Exacerbation was defined in multiple ways: the patient’s subjective complaint, symptom definition, requiring prescription change, requiring antibiotic treatment, or requiring hospital admission.
Exacerbation frequency (events per person per year) was 0.78±1.16, 0.24±0.47, 0.20±0.43, 0.13±0.28 and 0.06±0.19 for subjective complaint and symptom, prescription, antibiotic and hospital admission definitions, respectively. Exacerbation events did not significantly affect the annual decline in forced expiratory volume in 1 s. A high St George’s Respiratory Questionnaire total score, especially activity score, and a low body mass index were strongly associated with exacerbation-free survival, exacerbation frequency and development of recurrent exacerbations.
Despite the low exacerbation frequency in our cohort, impaired health-related quality of life and weight loss were found to be independent risk factors for COPD exacerbations.
Abstract
Impaired health-related quality of life and weight loss are independent risk factors for COPD exacerbations http://ow.ly/qQRAG
Footnotes
For editorial comments see page 1220.
This article has supplementary material available from www.erj.ersjournals.com
Support statement: This study was supported by a scientific research grant to the Hokkaido COPD Cohort Study from the Ministry of Education, Science, Culture and Sports of Japan (17390239 and 2139053 to M. Nishimura), Nippon Boehringer Ingelheim (Tokyo, Japan), Pfizer Inc. (Tokyo, Japan) and a grant to the Respiratory Failure Research Group H23-nanchi-ippan-024) from the Ministry of Health, Labor and Welfare, Japan.
Conflict of interest: Disclosures can be found alongside the online version of this article at www.erj.ersjournals.com
- Received June 28, 2013.
- Accepted October 27, 2013.
- ©ERS 2014