Predictors of exacerbation frequency in chronic obstructive pulmonary disease

European Journal of Medical Research

Zhaohui Tong¹  Shuo Zhang²  Yanwei Shi²  Wei’An Guo²  Erming Zhang²  Pingchao Xiang²  Hui Yang² 

[1] Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital Beijing, Capital Medical University, No. 8 Gong Ti Southern Road, Chao Yang District, Beijing 100020, China;Department of Respiratory and Critical Care Medicine, Shou-Gang Hospital Affiliated to Peking University, No.9 Jin Yuan Village Road, Shi Jing Shan District, Beijing 100041, China

关键词: Positive pressure ventilation;    Comorbidity;    Forced expiratory volume;    Exacerbation;    Chronic obstructive pulmonary disease;   

Others  :  817489
DOI  :  10.1186/2047-783X-19-18

 received in 2013-04-27, accepted in 2014-01-17,  发布年份 2014

【 摘 要 】

Background

Exacerbations of chronic obstructive pulmonary disease (COPD) are sporadic, acute worsening of symptoms. Identifying predictors of exacerbation frequency may facilitate medical interventions that reduce exacerbation frequency and severity. The objective of this study was to determine predictors of exacerbation frequency and mortality.

Methods

A total of 227 COPD patients were enrolled in a prospective clinical study between January 2000 and December 2011. Reported exacerbations were recorded for the year preceding enrollment and annually thereafter, and patients were grouped by median annual exacerbation frequency into those experiencing infrequent exacerbations (less than one exacerbation annually) and frequent exacerbations (one or more exacerbation annually). Patients experiencing frequent exacerbations were further divided into those experiencing moderately frequent exacerbations (fewer than two exacerbations per year) and severely frequent exacerbations (two or more exacerbations per year). The rate of clinical relapse and survival was recorded over a 10-year period. The mean of follow-up time was 5.15 years per patient.

Results

For patients experiencing infrequent, moderately frequent, and severely frequent exacerbations, median exacerbations in the year preceding enrollment were 0.0, 0.5, 1.0, respectively, and more frequent exacerbations correlated with lower baseline forced expiratory volume in one second (FEV₁) (0.81 L, 0.75 L, and 0.66 L, respectively), higher comorbidity (70.7%, 75.0%, and 89.4%, respectively), and greater NPPV use during hospitalization (16.4%, 35.9% and 51.1%, respectively). FEV₁ declined and mortality increased with increasing exacerbation frequency.

Conclusions

Exacerbation frequency can be used to generate discreet patient subpopulations, supporting the hypothesis that multiple COPD phenotypes exist and can be used in patient risk stratification.

【 授权许可】

   
2014 Yang et al.; licensee BioMed Central Ltd.

【 图 表 】

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