Predictors of exacerbations in chronic obstructive pulmonary disease--results from the Bergen COPD cohort study.

PLoS One 2014 3;9(10):e109721. Epub 2014 Oct 3.

Dept. of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Dept. of Clinical Science, University of Bergen, Bergen, Norway.

Background: COPD exacerbations accelerate disease progression.

Aims: To examine if COPD characteristics and systemic inflammatory markers predict the risk for acute COPD exacerbation (AECOPD) frequency and duration.

Methods: 403 COPD patients, GOLD stage II-IV, aged 44-76 years were included in the Bergen COPD Cohort Study in 2006/07, and followed for 3 years. Examined baseline predictors were sex, age, body composition, smoking, AECOPD the last year, GOLD stage, Charlson comorbidity score (CCS), hypoxemia (PaO2<8 kPa), cough, use of inhaled steroids, and the inflammatory markers leucocytes, C-reactive protein (CRP), neutrophil gelatinase associated lipocalin (NGAL), soluble tumor necrosis factor receptor 1 (sTNF-R1), and osteoprotegrin (OPG). Negative binomial models with random effects were fitted to estimate the annual incidence rate ratios (IRR). For analysis of AECOPD duration, a generalized estimation equation logistic regression model was fitted, also adjusting for season, time since inclusion and AECOPD severity.

Results: After multivariate adjustment, significant predictors of AECOPD were: female sex [IRR 1.45 (1.14-1.84)], age per 10 year increase [1.23 (1.03-1.47)], >1 AECOPD last year before baseline [1.65 (1.24-2.21)], GOLD III [1.36 (1.07-1.74)], GOLD IV [2.90 (1.98-4.25)], chronic cough [1.64 (1.30-2.06)] and use of inhaled steroids [1.57 (1.21-2.05)]. For AECOPD duration more than three weeks, significant predictors after adjustment were: hypoxemia [0.60 (0.39-0.92)], years since inclusion [1.19 (1.03-1.37)], AECOPD severity; moderate [OR 1.58 (1.14-2.18)] and severe [2.34 (1.58-3.49)], season; winter [1.51 (1.08-2.12)], spring [1.45 (1.02-2.05)] and sTNF-R1 per SD increase [1.16 (1.00-1.35)].

Conclusion: Several COPD characteristics were independent predictors of both AECOPD frequency and duration.

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109721PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184893PMC
January 2016
29 Reads

Publication Analysis

Top Keywords

bergen copd
8
aecopd frequency
8
copd cohort
8
cohort study
8
gold stage
8
aecopd year
8
copd characteristics
8
copd
7
aecopd
6
[136 107-174]
4
gold [290
4
107-174] gold
4
iii [136
4
gold iii
4
[157 121-205]
4
steroids [157
4
inhaled steroids
4
[164 130-206]
4
chronic cough
4
124-221] gold
4

Similar Publications