Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?

BACKGROUND: 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 exacerbati...

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Autores principales: Kim, Junghyun, Kim, Woo Jin, Lee, Chang-Hoon, Lee, Sang Haak, Lee, Myung-Goo, Shin, Kyeong-Cheol, Yoo, Kwang Ha, Lee, Ji-Hyun, Lim, Seong Yong, Na, Ju Ock, Hwang, Hun-Gyu, Hong, Yoonki, Lim, Myoung Nam, Yoo, Chul-Gyu, Jung, Ki Suck, Lee, Sang-Do
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450062/
https://www.ncbi.nlm.nih.gov/pubmed/28558829
http://dx.doi.org/10.1186/s12931-017-0587-9
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author Kim, Junghyun
Kim, Woo Jin
Lee, Chang-Hoon
Lee, Sang Haak
Lee, Myung-Goo
Shin, Kyeong-Cheol
Yoo, Kwang Ha
Lee, Ji-Hyun
Lim, Seong Yong
Na, Ju Ock
Hwang, Hun-Gyu
Hong, Yoonki
Lim, Myoung Nam
Yoo, Chul-Gyu
Jung, Ki Suck
Lee, Sang-Do
author_facet Kim, Junghyun
Kim, Woo Jin
Lee, Chang-Hoon
Lee, Sang Haak
Lee, Myung-Goo
Shin, Kyeong-Cheol
Yoo, Kwang Ha
Lee, Ji-Hyun
Lim, Seong Yong
Na, Ju Ock
Hwang, Hun-Gyu
Hong, Yoonki
Lim, Myoung Nam
Yoo, Chul-Gyu
Jung, Ki Suck
Lee, Sang-Do
author_sort Kim, Junghyun
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12931-017-0587-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-54500622017-06-01 Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? Kim, Junghyun Kim, Woo Jin Lee, Chang-Hoon Lee, Sang Haak Lee, Myung-Goo Shin, Kyeong-Cheol Yoo, Kwang Ha Lee, Ji-Hyun Lim, Seong Yong Na, Ju Ock Hwang, Hun-Gyu Hong, Yoonki Lim, Myoung Nam Yoo, Chul-Gyu Jung, Ki Suck Lee, Sang-Do Respir Res Research BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12931-017-0587-9) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-30 2017 /pmc/articles/PMC5450062/ /pubmed/28558829 http://dx.doi.org/10.1186/s12931-017-0587-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kim, Junghyun
Kim, Woo Jin
Lee, Chang-Hoon
Lee, Sang Haak
Lee, Myung-Goo
Shin, Kyeong-Cheol
Yoo, Kwang Ha
Lee, Ji-Hyun
Lim, Seong Yong
Na, Ju Ock
Hwang, Hun-Gyu
Hong, Yoonki
Lim, Myoung Nam
Yoo, Chul-Gyu
Jung, Ki Suck
Lee, Sang-Do
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title_full Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title_fullStr Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title_full_unstemmed Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title_short Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
title_sort which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450062/
https://www.ncbi.nlm.nih.gov/pubmed/28558829
http://dx.doi.org/10.1186/s12931-017-0587-9
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