Prediction of Acute Respiratory Disease in Current and Former Smokers With and Without COPD

Bowler, Russell P.; Kim, Victor; Regan, Elizabeth A.; Williams, André; Santorico, Stephanie A.; Make, Barry J.; Lynch, David A.; Hokanson, John E.; Washko, George R.; Bercz, Peter A.; Soler, Xavier; Marchetti, Nathaniel; Criner, Gerard J.; Ramsdell, Joe; Han, MeiLan K.; DeMeo, Dawn L.; Anzueto, Antonio; Comellas, Alejandro P.; Crapo, James D.; Dransfield, Mark T.; Wells, James M.; Hersh, Craig P.; MacIntyre, Neil R.; Martínez, Fernando J.; Nath, Hrudaya; Niewoehner, Dennis E.; Sciurba, Frank C.; Sharafkhaneh, Amir; Silverman, Edwin K.; Beek, Edwin Jacques Rudolph van; Wilson, Carla; Wendt, Christine; Wise, Robert A.

doi:10.1378/chest.13-2946

Cited by 76 publications

(73 citation statements)

References 37 publications

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“…Poor nutritional status, diabetes, low FEV 1 was other causes of morbidity after discharge. These findings were in similar to another study by Steer et al 35 The duration of exacerbation was significantly associated with its severity and season, which is in accordance to other studies. [29][30][31] It was also shown that a patient with exacerbations in the past is more likely to show them in future too, most of them requiring hospitalization.…”

Section: Discussionsupporting

confidence: 93%

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Acute exacerbation of chronic obstructive pulmonary disease: predictors of outcome: single center prospective study from India

Reddy

Polu

2016

Int J Adv Med

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Section: Discussionsupporting

confidence: 93%

“…This was in accordance to other studies by Husebo et al and others. [32][33][34][35] There was no difference in the number of exacerbations between the smokers and ex-smokers. This could conclude that the stoppage of the smoking was too late.…”

Section: Discussionmentioning

confidence: 87%

Acute exacerbation of chronic obstructive pulmonary disease: predictors of outcome: single center prospective study from India

Reddy

Polu

2016

Int J Adv Med

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“…Both of these groups have been demonstrated to have significant respiratory symptoms and impairment, in some cases greater than subjects with GOLD stage 1 COPD, and as we observed, they are also often treated with long-acting bronchodilators and inhaled corticosteroids despite no evidence to support that practice (9,10,19,29). We can only speculate about why no relationships between acute respiratory events and FEV 1 decline were observed in these subjects.…”

Section: Discussionmentioning

confidence: 53%

“…Although many COPD treatments reduce exacerbation frequency and some studies suggest that inhaled therapies may reduce FEV 1 decline (7,8), there is no information about the association between these two key disease features. Many smokers without COPD also suffer acute respiratory events that appear clinically similar to classic exacerbations in those with established COPD (9,10). Whether such respiratory events accelerate lung function loss or lead to the development of COPD is unknown.…”

Section: Measurements and Main Resultsmentioning

confidence: 99%

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

Dransfield

Kunisaki

Strand

et al. 2017

Am J Respir Crit Care Med

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276

219

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Rationale: Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown.Objectives: To determine the association between acute exacerbations of COPD (and acute respiratory events in smokers without COPD) and the change in lung function over 5 years of follow-up.Methods: We examined data on the first 2,000 subjects who returned for a second COPDGene visit 5 years after enrollment. Baseline data included demographics, smoking history, and computed tomography emphysema. We defined exacerbations (and acute respiratory events in those without established COPD) as acute respiratory symptoms requiring either antibiotics or systemic steroids, and severe events by the need for hospitalization. Throughout the 5-year follow-up period, we collected self-reported acute respiratory event data at 6-month intervals. We used linear mixed models to fit FEV 1 decline based on reported exacerbations or acute respiratory events. Measurements and Main Results:In subjects with COPD, exacerbations were associated with excess FEV 1 decline, with the greatest effect in Global Initiative for Chronic Obstructive Lung Disease stage 1, where each exacerbation was associated with an additional 23 ml/yr decline (95% confidence interval, 2-44; P = 0.03), and each severe exacerbation with an additional 87 ml/yr decline (95% confidence interval, 23-151; P = 0.008); statistically significant but smaller effects were observed in Global Initiative for Chronic Obstructive Lung Disease stage 2 and 3 subjects. In subjects without airflow obstruction, acute respiratory events were not associated with additional FEV 1 decline.Conclusions: Exacerbations are associated with accelerated lung function loss in subjects with established COPD, particularly those with mild disease. Trials are needed to test existing and novel therapies in subjects with early/mild COPD to potentially reduce the risk of progressing to more advanced lung disease.Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).

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“…Conversely, COPD exacerbations appear to impact the risk of cardiovascular events [70]. Although acute exacerbations of respiratory symptoms occur more frequently in patients with COPD, they also occur with significant frequency in smokers without COPD, suggesting that they are not specific for COPD [71,72]. Patients with COPD have a similar prevalence of sleep apnoea as the general population.…”

Section: Phenotypingmentioning

confidence: 99%

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

et al. 2015

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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management.Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified.Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus.Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes. @ERSpublications ATS/ERS statement: which types of research will have the greatest future impact on patientcentred outcomes in COPD? http://ow.ly/I54Hb

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Prediction of Acute Respiratory Disease in Current and Former Smokers With and Without COPD

Abstract: Although acute episode of respiratory disease rates are higher in subjects with COPD, risk factors are similar, and at a population level, there are more episodes in smokers without COPD.

Cited by 76 publications

References 37 publications

Acute exacerbation of chronic obstructive pulmonary disease: predictors of outcome: single center prospective study from India

Acute exacerbation of chronic obstructive pulmonary disease: predictors of outcome: single center prospective study from India

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

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