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Published on: November 8, 2013
Clinical characteristics and longitudinal prognosis of patients with mild-to-moderate chronic obstructive pulmonary
Xiaozi Guo1, Fan Wu2,3, Yingtong Chen4
1The Second Clinical College, Guangzhou Medical University, Guangzhou, China.
Background:
Lung function trajectories in chronic obstructive pulmonary disease (COPD) vary among individuals. However, evidence on the clinical characteristics and prognosis of mild-to-moderate COPD developing from different lung function trajectories is limited. We aim to explore whether differences exist in the clinical features and prognosis of mild-to-moderate COPD developed through different lung function trajectories.
Methods:
Individuals who participated in the Early COPD study (2019-2020) and who had available spirometry data from the China Epidemiological Survey of COPD (2012-2013) were included and categorized into three groups: (I) previously normal forced expiratory volume in one second (FEV1) trajectory group: participants had developed mild-to-moderate COPD in 2019-2020, with normal lung function in 2012-2013; (II) previously low FEV1 trajectory group: participants had developed mild-to-moderate COPD in 2019-2020, with subnormal lung function in 2012-2013; (III) non-COPD group: participants had not developed COPD in 2019-2020, with normal lung function in 2012-2013. Baseline assessments (2019-2020) included spirometry, impulse oscillometry (IOS), and chest computed tomography (CT). Lung function decline and exacerbation risk were analyzed over a 2-year follow-up (2021-2022).
Results:
Overall, 96 participants were included in the previously normal FEV1 trajectory group, 32 in the previously low FEV1 trajectory group, and 118 in the non-COPD group. Compared with the previously normal FEV1 trajectory group, the previously low FEV1 trajectory group had poorer lung function, more severe dyspnea, and greater small-airway dysfunction and emphysema. During the 2-year follow-up, the previously normal FEV1 trajectory group had a faster annual rate of forced vital capacity (FVC) decline, and the previously low FEV1 trajectory group had a higher moderate-to-severe exacerbation risk than the non-COPD group.
Conclusions:
There were significant differences in the clinical characteristics and longitudinal prognosis of mild-to-moderate COPD progressing from different pulmonary function trajectories, reflecting the need for individualized management.
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