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Factors associated with change in exacerbation frequency in COPD
Gavin C Donaldson1, Hanna Müllerova, Nicholas Locantore
1Centre for Respiratory Medicine, UCL Medical School, Royal Free Campus, Rowland Hill Street Hampstead, London NW3 2PF, UK. g.donaldson@ucl.ac.uk
Respiratory Research
|August 1, 2013
Summary
Most patients with chronic obstructive pulmonary disease (COPD) remain in their exacerbation frequency category year-to-year. However, some patients do change categories, and disease severity influences this transition.
Area of Science:
- Pulmonary Medicine
- Clinical Research
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) patients are categorized as frequent (FE) or infrequent (IE) exacerbators based on annual exacerbation events.
- While most patients maintain their exacerbation category, transitions between FE and IE occur.
- Factors influencing these category changes in COPD patients have not been well-examined.
Purpose of the Study:
- To investigate patient characteristics associated with changes in exacerbation frequency categories in COPD.
- To identify potential predictors of transitioning between infrequent and frequent exacerbation groups.
Main Methods:
- Analysis of 1832 patients from the ECLIPSE study with two-year follow-up.
- Exacerbations defined by healthcare utilization.
- Comparison of baseline characteristics between patients who changed or maintained their exacerbation category (IE to FE, FE to IE).
Main Results:
- 17% of IE patients transitioned to FE, and 39% of FE patients transitioned to IE between years 1 and 2.
- More severe disease was linked to IE to FE transitions; less severe disease to FE to IE transitions.
- Falls in FEV1 and 6-minute walking distance preceded IE to FE shifts; falls in platelet count preceded FE to IE shifts.
Conclusions:
- No single parameter clearly predicts an imminent change in exacerbation frequency category for COPD patients.
- Disease severity and minor physiological changes may indicate potential shifts in exacerbation patterns.
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