Abstract
OBJECTIVE: Our objective was to study predictors of frequent exacerbations in mild grade COPD patients in comparison with more severe COPD patients.
METHODS: We conducted a retrospective population-based cohort study including 723 patients with confirmed COPD and FEV1 data available.Exacerbation frequency was observed for the previous year (2011) and the following year (2012). Patients were defined as 'Frequent Exacerbator' (FE) phenotype if they suffered ≥ 2 exacerbations in a year, and were categorized according to severity of COPD (GOLD Grades 1-4). Odds Ratios and their 95% confidence intervals were estimated by logistic regression adjusting for Age, Gender and Smoking status.
RESULTS: 75 out of the 723 patients (10.4%) were classified as GOLD 1; 433 (59.9%) were GOLD 2; 190 (26.3%) GOLD 3 and 25 patients (3.5%) GOLD 4. The main predictor of being FE among all grades of COPD severity, was a history of frequent exacerbations the previous year. However, this association was higher in Mild-GOLD 1 patients: adjusted OR 15.90, in comparison with the rest of patients: adjusted OR GOLD 2 patients 4.20; OR GOLD 3 patients 6.58; OR GOLD 4 patients 4.24 .
CONCLUSIONS: The role of the FE phenotype on the risk of future exacerbations seem to be higher in patients with milder disease (GOLD 1), suggesting a higher susceptibility in these patients.
- Copyright ©the authors 2016