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...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1783239880318386176 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5450062 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT kimjunghyun whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT kimwoojin whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT leechanghoon whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT leesanghaak whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT leemyunggoo whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT shinkyeongcheol whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT yookwangha whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT leejihyun whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT limseongyong whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT najuock whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT hwanghungyu whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT hongyoonki whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT limmyoungnam whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT yoochulgyu whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT jungkisuck whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients AT leesangdo whichbronchodilatorreversibilitycriteriacanpredictsevereacuteexacerbationinchronicobstructivepulmonarydiseasepatients |