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05.09.2022 | COPD

Trajectories of Severe Exacerbations of Chronic Obstructive Pulmonary Disease and Their Relationship with Mortality Risk

verfasst von: Rafael Golpe, Juan Marco Figueira-Gonçalves, Carlos Antonio Amado-Diago, Andrea Expósito-Marrero, Laura González-Ramos, David Dacal-Rivas, Ignacio García-Talavera, Cristóbal Esteban

Erschienen in: Lung | Ausgabe 5/2022

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Abstract

Purpose

Acute exacerbations of COPD (AECOPD) are important factors contributing to mortality risk. The rate of exacerbations varies overtime. An inconsistent pattern of exacerbation occurrence is a common finding. The mortality risk associated with such a pattern is not entirely clear. Our objective was to assess the risk of mortality associated with various possible patterns of AECOPD trajectories.

Methods

This is a multicenter historical cohort study. Four different exacerbation trajectories were defined according to the incidence of severe AECOPD requiring hospital admission 2 years before and after the date of the first visit to the respiratory clinic—Consistent non-exacerbators (NEx): no AECOPD before or after the index date; consistent exacerbators (Ex): at least one AECOPD both before and after the index date; converters to exacerbators (CONV-Ex): no exacerbations before and at least one AECOPD after the index date; converters to non-exacerbators (CONV-NEx): at least one AECOPD before the index date, and no exacerbations after said date. All-cause mortality risk for these trajectories was assessed.

Results

A total of 1713 subjects were included in the study: NEx: 1219 (71.2%), CONV-NEx: 225 (13.1%), CONV-Ex: 148 (8.6%), Ex: 121 (7.1%). After correcting for confounding variables, the group with the highest mortality risk was Ex. The CONV-Ex and CONV-Nex groups had a mortality risk between Ex and NEx, with no significant differences between them.

Conclusion

Different possible trajectories of severe AECOPD before and after a first specialized consultation are associated with different mortality risks. An inconsistent pattern of exacerbations has a mortality risk between Ex and NEx, with no clear differences between CONV-Ex and CONV-NEx.

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Titel: Trajectories of Severe Exacerbations of Chronic Obstructive Pulmonary Disease and Their Relationship with Mortality Risk
verfasst von: Rafael Golpe
Juan Marco Figueira-Gonçalves
Carlos Antonio Amado-Diago
Andrea Expósito-Marrero
Laura González-Ramos
David Dacal-Rivas
Ignacio García-Talavera
Cristóbal Esteban
Publikationsdatum: 05.09.2022
Verlag: Springer US
Erschienen in: Lung / Ausgabe 5/2022
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-022-00565-8

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Trajectories of Severe Exacerbations of Chronic Obstructive Pulmonary Disease and Their Relationship with Mortality Risk