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Abstract: Background and Aim
Exacerbations of chronic obstructive pulmonary disease (COPD) carry significant consequences
for patients and are responsible for considerable health-care costs?particularly if
hospitalization is required. Despite the importance of hospitalized exacerbations, relatively
little is known about their determinants. This study aimed to analyze predictors of hospitalized
exacerbations and mortality in COPD patients.
This was a retrospective population-based cohort study.We selected 900 patients with confirmed
COPD aged 35 years by simple random sampling among all COPD patients in
Cantabria (northern Spain) on December 31, 2011. We defined moderate exacerbations as
events that led a care provider to prescribe antibiotics or corticosteroids and severe exacerbations
as exacerbations requiring hospital admission.We observed exacerbation frequency
over the previous year (2011) and following year (2012). We categorized patients
according to COPD severity based on forced expiratory volume in 1 second (Global Initiative
for Chronic Obstructive Lung Disease [GOLD] grades 1?4). We estimated the odds
ratios (ORs) by logistic regression, adjusting for age, sex, smoking status, COPD severity,
and frequent exacerbator phenotype the previous year.
Of the patients, 16.4%had 1 severe exacerbations, varying from 9.3%in mild GOLD grade
1 to 44%in very severe COPD patients. A history of at least two prior severe exacerbations
was positively associated with new severe exacerbations (adjusted OR, 6.73; 95%confidence interval [CI], 3.53?12.83) and mortality (adjusted OR, 7.63; 95%CI, 3.41?17.05). Older age
and several comorbidities, such as heart failure and diabetes, were similarly associated.
Hospitalized exacerbations occurred with all grades of airflow limitation. A history of severe
exacerbations was associated with new hospitalized exacerbations and mortality.
Fuente: PLoS One. 2016;11(6):e0158727
Editorial: Public Library of Science
Año de publicación: 2016
Nº de páginas: 13
Tipo de publicación: Artículo de Revista
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MIGUEL SANTIBAÑEZ MARGÜELLO
RUIZ NÚÑEZ, MARIO
HELGUERA, JOSÉ MANUEL
GARCÍA RIVERO, JUAN LUIS