Exacerbations of COPD

Viniol, Christian; Vogelmeier, Claus

doi:10.1183/16000617.0103-2017

Cited by 225 publications

(192 citation statements)

References 91 publications

(83 reference statements)

Supporting

Mentioning

180

Contrasting

Unclassified

Order By: Relevance

“…Over the past decade, the relation between air pollution exposure and AECOPD has been investigated in several studies, but the results were non‐conclusive. Some epidemiological studies have demonstrated that short‐time exposure to air pollution significantly increased the risk of exacerbations, whereas others found no causality or association with only for selected pollutants …”

Section: Smoking and Air Pollutionmentioning

confidence: 99%

“…The eosinophil count is a marker for eosinophilic airway inflammation and a predictive biomarker for the efficacy of ICS treatment in patients with COPD exacerbations . COPD patients with eosinophilia (≥2%) have an increased risk of AECOPD . The first study to investigate the prevalence of blood eosinophilia (defined as ≥300 cells/L) among inpatients with AECOPD evidenced a higher frequency of exacerbations during the 1‐year follow‐up period compared to patients without eosinophilia .…”

Section: Biomarkersmentioning

confidence: 99%

“…The most common isolated microorganisms were Pseudomonas aeruginosa (4.16%) and Acinetobacter baumannii (4.16%) . Chronic pathogenic colonisation, especially with Pseudomonas aeruginosa , present in patients with COPD and bronchiectasis, is considered a potential mechanism for frequent AECOPD …”

Section: Comorbiditiesmentioning

confidence: 99%

“…Anxiety and depression are commonly associated with COPD and have a negative effect on exacerbations . Among COPD patients the prevalence of depression varies between 6% and 50% and of anxiety between 10% and 15.8%, depending on diagnostic methods .…”

Section: Comorbiditiesmentioning

confidence: 99%

“…The natural course of COPD is worsened by repeated episodes of exacerbations, which are defined as an acute worsening of respiratory symptoms requiring a change in treatment COPD exacerbations are important events associated with high impact on health status in COPD patients and it is well known that they are also a major determinant in disease progression, with inexorable decline of lung function . Severe exacerbations requiring hospitalisation are associated with a high risk of a subsequent exacerbation, a rapid decline in health status and high mortality in the weeks following every severe exacerbation .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Risk factors of chronic obstructive pulmonary disease exacerbations

Hogea

Tudorache

Fildan

et al. 2020

Clinical Respiratory J

View full text Add to dashboard Cite

Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory disease characterised by persistent respiratory symptoms and airflow limitation. COPD has a major impact on public health, mainly because of its increasing prevalence, morbidity and mortality. The natural course of COPD is aggravated by episodes of respiratory symptom worsening termed exacerbations that contribute to disease progression. Acute Exacerbations of COPD (AECOPD) can be triggered by a multitude of different factors, including respiratory tract infections, various exposures, prior exacerbations, non‐adherence to treatment and associated comorbidities. AECOPD are associated with an inexorable decline of lung function and a significantly worse survival outcome. This review will summarise the most important aspects regarding the impact of different factors that contribute to COPD exacerbations.

show abstract

Section: Smoking and Air Pollutionmentioning

confidence: 99%

Section: Biomarkersmentioning

confidence: 99%

Section: Comorbiditiesmentioning

confidence: 99%

Section: Comorbiditiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk factors of chronic obstructive pulmonary disease exacerbations

Hogea

Tudorache

Fildan

et al. 2020

Clinical Respiratory J

View full text Add to dashboard Cite

show abstract

Estimated Cardiorespiratory Hospitalizations Attributable to Influenza and Respiratory Syncytial Virus Among Long-term Care Facility Residents

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Older adults residing in long-term care facilities (LTCFs) are at a high risk of being infected with respiratory viruses, such as influenza and respiratory syncytial virus (RSV). Although these infections commonly have many cardiorespiratory sequelae, the national burden of influenzaand RSV-attributable cardiorespiratory events remains unknown for the multimorbid and vulnerable LTCF population.OBJECTIVE To estimate the incidence of cardiorespiratory hospitalizations that were attributable to influenza and RSV among LTCF residents and to quantify the economic burden of these hospitalizations on the US health care system by estimating their associated cost and length of stay. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used national MedicareProvider Analysis and Review inpatient claims and Minimum Data Set clinical assessments for 6 respiratory seasons (2011)(2012)(2013)(2014)(2015)(2016)(2017). Long-stay residents of LTCFs were identified as those living in the facility for at least 100 days (index date), aged 65 years or older, and with 6 months of continuous enrollment in Medicare Part A were included. Follow-up occurred from the resident's index date until the first hospitalization, discharge from the LTCF, disenrollment from Medicare, death, or the end of the study. Residents could re-enter the sample; thus, long-stay episodes of care were identified. Data analysis was performed between January 1 and September 30, 2020.EXPOSURES Seasonal circulating pandemic 2009 influenza A(H1N1), human influenza A(H3N2), influenza B, and RSV. MAIN OUTCOMES AND MEASURESCardiorespiratory hospitalizations (eg, asthma exacerbation, heart failure) were identified using primary diagnosis codes. Influenza-and RSV-attributable cardiorespiratory events were estimated using a negative binomial regression model adjusted for weekly circulating influenza and RSV testing data. Length of stay and costs of influenza-and RSV-attributable events were then estimated. RESULTSThe study population comprised 2 909 106 LTCF residents with 3 138 962 long-stay episodes and 5 079 872 person-years of follow-up. Overall, 10 939 (95% CI, 9413-12 464) influenzaand RSV-attributable cardiorespiratory events occurred, with an incidence of 215 (95% CI, 185-245) events per 100 000 person-years. The cost of influenza-and RSV-attributable cardiorespiratory events was $91 055 393 (95% CI, $77 885 316-$104 225 470), and the length of stay was 56 858 (95% CI, 48 757-64 968) days. CONCLUSIONS AND RELEVANCEThis study found that many cardiorespiratory hospitalizations among LTCF residents in the US were attributable to seasonal influenza and RSV. To minimize the (continued) Key Points Question What is the burden of cardiorespiratory events attributable to influenza and respiratory syncytial virus (RSV) among older adults residing in long-term care facilities (LTCFs) in the US? Findings In this cohort study of 2 909 106 LTCF residents, a total of 10 939 influenza-and RSV-attributable cardiorespiratory events occurred from 2011 to 2017 f...

show abstract

GOLD COPD Exacerbation History Categories and Disease Outcomes

Waeijen-Smit,

Peerlings,

Jörres

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportancePrevious exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with future events. For more than a decade, patients at high risk have been defined as individuals with a history of 2 or more moderate ECOPD, 1 or more severe ECOPD, or both within 12 months, and treatments have been allocated accordingly, but these cutoffs lack validation.ObjectivesTo validate ECOPD history categories by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and explore alternative cutoffs to estimate moderate and severe ECOPD and all-cause mortality in COPD.Design, Setting, and ParticipantsThis cohort study analyzed data from patients with COPD in the German COPD and Systemic Consequences-Comorbidities Network (COSYCONET) study. Patients were recruited from September 2010 to December 2013. Analyses were conducted in September 2023 to August 2024.Main Outcomes and MeasuresRisk of moderate and severe (ie, with hospitalization) ECOPD and all-cause mortality over a 4.5-year follow-up period were assessed using binomial logistic regressions and area under the receiver operating characteristic curves (AUROCs) with 95% CIs.ResultsAmong 2291 patients with COPD GOLD categories 1 to 4 (mean [SD] age, 65 [8] years; 1396 male [60.9%]), the mean (SD) estimated forced expiratory volume in the first second of expiration was 52.5% (18.6%). ECOPD history categories by GOLD had an AUROC of 0.63 (95% CI, 0.60-0.65) and 0.62 (95% CI, 0.58-0.66) to estimate moderate and severe ECOPD, respectively. A single previous moderate ECOPD within 12 months more accurately estimated future moderate and severe ECOPD (AUROC, 0.66; 95% CI, 0.64-0.69), and in line with GOLD, 1 previous severe ECOPD within 12 months estimated moderate and severe ECOPD (AUROC, 0.63; 95% CI, 0.60-0.67). The 4-year mortality rate was 219 patients (9.6%). Patients with 3 or more previous moderate ECOPD (odds ratio, 2.18; 95% CI, 1.27-3.72) or 1 or more previous severe ECOPD (odds ratio, 1.57; 95% CI, 1.29-1.91) within 12 months were more likely to die compared with patients without prior ECOPD.Conclusions and RelevanceThis study’s findings suggest a limited estimative performance of ECOPD history categories by GOLD. Novel cutoffs were suggested, categorizing patients as without exacerbations or with high-risk exacerbations based on a history of 1 or more moderate ECOPD, 1 or more severe ECOPD, or both within 12 months.

show abstract

Exacerbations of COPD

Cited by 225 publications

References 91 publications

Risk factors of chronic obstructive pulmonary disease exacerbations

Risk factors of chronic obstructive pulmonary disease exacerbations

Estimated Cardiorespiratory Hospitalizations Attributable to Influenza and Respiratory Syncytial Virus Among Long-term Care Facility Residents

GOLD COPD Exacerbation History Categories and Disease Outcomes

Contact Info

Product

Resources

About