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Measuring the Frequency of Exacerbation among Patients with Obstructive Airway Disease and the Factors Associated
Prachi Jalan1, Archana Gautam2, Chetan Pande2
1Department of Anesthiology, Symbiosis Institute of Health Sciences, Symbiosis Medical College for Women, Symbiosis International (Deemed) University, Pune, Maharashtra, India.
Background:
Obstructive airway diseases such as asthma and chronic obstructive pulmonary disease are marked by the episodes of worsening symptoms that drive morbidity and healthcare utilization. Understanding how often these exacerbations occur and which patient factors predict them is essential for preventive care.
Aim:
To quantify the annual frequency of exacerbations in adult patients with obstructive airway disease and to identify the demographic, clinical and treatment-related factors associated with frequent exacerbations.
Materials And Methods:
One hundred adult patients with confirmed obstructive airway disease under follow-up at a tertiary respiratory therapy unit were enrolled over 12 months. Exacerbations were defined as events requiring increased treatment unscheduled medical contact or hospitalization. Data collected included age, sex, disease, duration, smoking history, comorbidities, baseline lung function, inhaler adherence, and prior hospitalizations. Patients with two or more exacerbations per year were classified as frequent exacerbators. Logistic regression identified the independent predictors of frequent exacerbations.
Results:
Participants had a mean age of 55 ± 10 years and 60% were male. The mean annual exacerbation rate was 1.8 ± 1.2 and 40% met the criteria for frequent exacerbations. Those patients had lower baseline lung function with forced expiratory volume-one 48% ±8% predicted compared with 65% ±10% in others poorer inhaler adherence 75% versus 17% higher smoking exposure 15 ± 5 versus 8 ± 4 pack years and more comorbidities 63% versus 25%. In multivariable analysis, poor adherence, low lung function, smoking history, and multiple comorbidities were the each independent predictor with odds ratios from 2.5 to 4.2.
Conclusion:
Exacerbations are common in obstructive airway disease and disproportionately affect patients, with low lung function, multiple comorbidities, significant smoking history, and poor inhaler adherence. Regular risk factor assessment and adherence support interventions could reduce exacerbation frequency and improve patient outcomes.
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