Treatable traits identified in Chinese patients hospitalized with AECOPD: A Multicenter Cohort Study

Background: "Treatable traits (TTs)" is a precision medicine strategy for the management of chronic airway diseases. However, data on TTs in hospitalized AECOPD patients are limited. This study aimed to determine the prevalence of TTs in Chinese patients hospitalized with AECOPD and which traits predict future exacerbation risk, and to develop an exacerbation prediction model. Methods: This multicenter, cohort study recruited patients hospitalized with AECOPD from January 2022 to April 2023. Participants underwent a multidimensional assessment to characterize the TTs and were then followed up for one year. Cox regression analyses were used to determine the association between TTs and future exacerbations and develop a prediction model. Results: Finally, 28 TTs, including pulmonary (n=11), extra-pulmonary (n=12) and behavioral/risk factors (n=5) were identified. Five traits were associated with increased risk of future AECOPD readmission, including frequent exacerbations in the past year (adjusted HR: 2.079, 95% CI: 1.246-3.469), O₂ desaturation (adjusted HR: 1.754, 95% CI: 1.001-3.075), eosinophilic airway inflammation (adjusted HR: 1.731, 95% CI: 1.078-2.777), pathogen colonization (adjusted HR: 1.852, 95% CI: 1.147-2.990) and gastroesophageal reflux (adjusted HR: 5.500, 95% CI: 1.923-15.730). Furthermore, one regression model was developed to predict personalized exacerbation risk and showed acceptable performance. Conclusion: TTs can be systematically assessed in Chinese patients hospitalized with AECOPD, some of which are associated with future exacerbation-related readmission.