Abstract
Background: Differences in exacerbation history may influence prognosis of COPD.
Objectives: We hypothesized that prognosis differs between individuals with a history of only medically treated exacerbations (moderate) and those with a history of hospitalised exacerbations (severe).
Methods: In 98 614 adults from the Copenhagen General Population Study, we assessed risk of moderate and severe exacerbations, pneumonia hospitalisation, and death from 2003 until 2013 according to exacerbation history.
Results: In 6545 individuals with COPD, 6290 had no exacerbations in the preceding year, 109 had one moderate exacerbation, 108 had two or more moderate exacerbations, and 38 had one or more severe exacerbations. In total, we observed 926 moderate and 244 severe exacerbations, 477 pneumonias, and 707 deaths. Compared to individuals without previous exacerbations, lung function and symptom adjusted HRs for future moderate exacerbation were 4.68(95% CI:3.31-6.62) for individuals with one previous moderate exacerbation, 21(13-33) for individuals with two or more previous moderate exacerbations, and 5.30(3.44-8.15) for individuals with one or more previous severe exacerbations. Corresponding HRs were 1.62(0.78-3.34), 1.29(0.57-2.89), and 5.43(2.56-12) for severe exacerbation, 1.86(1.06-3.27), 1.74(1.01-2.99), and 4.85(2.94-8.02) for pneumonia, 0.53(0.10-2.99), 1.65(0.53-5.17), and 2.98(1.14-7.83) for respiratory mortality, and 1.34(0.79-2.29), 1.57(1.00-2.47), and 1.49(0.85-2.62) for all-cause mortality, respectively.
Conclusions: Individuals with COPD and a history of hospitalised exacerbations carried the poorest prognosis compared to those with a history of only medically treated exacerbations.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3328.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019