The online version of this article (doi:10.1186/s12931-017-0587-9) contains supplementary material, which is available to authorized users.
It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients.
Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study. The assessed BDR criteria included the Global Initiative for Chronic Obstructive Lung Disease (GOLD), American Thoracic Society (ATS), American College of Chest Physicians, (ACCP), major criteria of the Spanish definition of asthma-COPD overlap syndrome (ACOS), criteria compatible with ACOS in the Global Initiative for Asthma (GINA), and European Respiratory Society (ERS). The rate of patients with severe AE who required hospitalization within 1 year due to BDR results according to each set of criteria was analyzed using logistic regression models.
Among a total of 854 patients, the BDR-positive cases varied according to the criteria used. There was a 3.5% positive BDR rate according to GINA and a 29.9% rate according to the ATS criteria. Positive BDR according to the GOLD criteria was significantly associated with a decreased risk of severe AE (adjusted odds ratio (aOR) = 0.38; 95% Confidence interval (CI) = 0.15–0.93). This result remained statistically significant even in a sensitivity analysis that included only participants with a smoking history of at least 10 pack-years and in the analysis for the propensity score-matched participants.
Among different criteria for positive BDR, the use of the GOLD ones was significantly associated with a decreased risk of severe AE in COPD patients. Increase use of ICS/LABA may have affected this relationship.
Additional file 1: Supplement data. (DOCX 44 kb)12931_2017_587_MOESM1_ESM.docx
Global Initiative for Chronic Obstructive Lung Disease(GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2016. Available from: http://www.goldcopd.org/. 2016.
Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347–65. CrossRefPubMed
American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis. 1991;144(5):1202–18. CrossRef
Report of the Committee on Emphysema American College of Chest Physicians. Criteria for the assessment of reversibility in airways obstruction. Chest. 1974;65(5):552–3. CrossRef
Soler-Catalu˜na JJ, Cosío B, Izquierdo JL, López-Campos JL, Marín JM, Agüero R, Baloira A, Carrizo S, Esteban C, Galdiz JB, González MC, Miravitlles M, Monsó E, Montemayor T, Morera J, Ortega F, Peces-Barba G, Puente L, Rodríguez JM, Sala E, Sauleda J, Soriano JB, Viejor JL. Consensus Document on the Overlap Phenotype COPD–Asthma in COPD. Arch Bronconeumol. 2012;48(9):331–7.
Diagnosis of Diseases of Chronic Airflow Limitation:Asthma, COPD and Asthma-COPD Overlap Syndrome(ACOS). Updated 2015. Available from: http://www.goldcopd.org/. 2015.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J, Force AET. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38. CrossRefPubMed
Pennock BE, Rogers RM, McCaffree R. Changes in measured spirometric indices. Chest. 1981;80:91–9. CrossRef
DiSantostefano RL, Li H, Rubin DB, Stempel DA. Which patients with chronic obstructive pulmonary disease benefit from the addition of an inhaled corticosteroid to their bronchodilator? A cluster analysis. BMJ Open. 2013;3(4):e001838-e. CrossRef
- Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
Woo Jin Kim
Sang Haak Lee
Kwang Ha Yoo
Seong Yong Lim
Ju Ock Na
Myoung Nam Lim
Ki Suck Jung
- BioMed Central
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