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Trajectories of severe exacerbations of chronic obstructive pulmonary disease and their relationship with mortality risk

Abstract: Purpose: Acute exacerbations of COPD (AECOPD) are important factors contributing to mortality risk. The rate of exacerbations varies overtime. An inconsistent pattern of exacerbation occurrence is a common finding. The mortality risk associated with such a pattern is not entirely clear. Our objective was to assess the risk of mortality associated with various possible patterns of AECOPD trajectories. Methods: This is a multicenter historical cohort study. Four different exacerbation trajectories were defined according to the incidence of severe AECOPD requiring hospital admission 2 years before and after the date of the first visit to the respiratory clinic-Consistent non-exacerbators (NEx): no AECOPD before or after the index date; consistent exacerbators (Ex): at least one AECOPD both before and after the index date; converters to exacerbators (CONV-Ex): no exacerbations before and at least one AECOPD after the index date; converters to non-exacerbators (CONV-NEx): at least one AECOPD before the index date, and no exacerbations after said date. All-cause mortality risk for these trajectories was assessed. Results: A total of 1713 subjects were included in the study: NEx: 1219 (71.2%), CONV-NEx: 225 (13.1%), CONV-Ex: 148 (8.6%), Ex: 121 (7.1%). After correcting for confounding variables, the group with the highest mortality risk was Ex. The CONV-Ex and CONV-Nex groups had a mortality risk between Ex and NEx, with no significant differences between them. Conclusion: Different possible trajectories of severe AECOPD before and after a first specialized consultation are associated with different mortality risks. An inconsistent pattern of exacerbations has a mortality risk between Ex and NEx, with no clear differences between CONV-Ex and CONV-NEx.

 Fuente: Lung . 2022 Oct;200(5):601-607

 Editorial: Springer Nature

 Fecha de publicación: 01/10/2022

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1007/s00408-022-00565-8

 ISSN: 0341-2040,1432-1750

 Url de la publicación: https://doi.org/10.1007/s00408-022-00565-8

Autoría

GOLPE, RAFAEL

FIGUEIRA-GONÇALVES, ANDREA

EXPÓSITO-MARRERO, ANDREA

GONZÁLEZ-RAMOS, LAURA

DACAL-RIVAS, DAVID

GARCÍA-TALAVERA, IGNACIO

ESTEBAN, CRISTÓBAL