Airflow reversibility and long-term outcomes in patients with COPD without comorbidities

Marín, J.; Ciudad, Maria; Moya, Virginia; Carrizo, Santiago; Bello, Salvador; Piras, Bastiana; Celli, Bartolomé R.; Miravitlles, Marc

doi:10.1016/j.rmed.2014.05.006

Cited by 18 publications

(18 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This figure fell within the range of reversibility detected by other authors in a similar percentage of patients (21%–27.6%). 13 , 22 Furthermore, the FEV 1 of patients with a positive bronchodilator response in our study was higher than that of the other phenotypes. Similar results were reported by Calle Rubio et al, 18 although this finding was not reported elsewhere.…”

Section: Discussioncontrasting

confidence: 54%

COPD phenotypes: differences in survival

Vázquez

García

Jiménez‐García

et al. 2018

COPD

View full text Add to dashboard Cite

BackgroundThe aim of the study was to analyze the characteristics and survival of a group of patients with COPD according to their clinical phenotype.Patients and methodsThe study population was selected from patients undergoing scheduled spirometry between January 1, 2011 and June 30, 2011 at the respiratory function laboratory of a teaching hospital and comprised those with a previous and confirmed diagnosis of COPD and forced expiratory volume in the first second (FEV1) of <70%. The patients selected were classified into 4 groups: positive bronchodilator response, non-exacerbator, exacerbator with emphysema, and exacerbator with chronic bronchitis. Patients were followed up until April 2017.ResultsWe recruited 273 patients, of whom 89% were men. The distribution by phenotype was as follows: non-exacerbator, 47.2%; positive bronchodilator response, 25.8%; exacerbator with chronic bronchitis, 13.8%; and exacerbator with emphysema, 13.0%. A total of 90 patients died during follow-up (32.9%). Taking patients with a positive bronchodilator response as the reference category, the risk factors that were independently associated with death were older age (HR, 1.06; 95% CI, 1.03–1.09), lower FEV1 (HR, 0.98; 95% CI, 0.96–0.99), and exacerbator with chronic bronchitis phenotype (HR, 3.28; 95% CI, 1.53–7.03).ConclusionClassification of COPD patients by phenotype makes it possible to identify subgroups with different prognoses. Thus, mortality was greater in exacerbators with chronic bronchitis and lower in those with a positive bronchodilator response.

show abstract

Section: Discussioncontrasting

confidence: 54%

COPD phenotypes: differences in survival

Vázquez

García

Jiménez‐García

et al. 2018

COPD

View full text Add to dashboard Cite

show abstract

“…For example, Marin et al reported a result similar to ours in that a positive BDR was significantly associated with a prolonged time to first hospitalization. However, theirs was a retrospective study [21]. Our results were somewhat different from PLATINO study, in which a positive BDR according to the ATS criteria and wheezing in the last 12 months showed a higher risk of hospitalization [11].…”

Section: Discussioncontrasting

confidence: 78%

“…The usefulness of BDR positivity as a prognostic factor has been controversial [8, 11, 21]. BDR positivity favors a good treatment outcome in some studies, but demonstrates poor disease related outcomes in others.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Lee

et al. 2017

Respir Res

View full text Add to dashboard Cite

BackgroundIt 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.MethodsPatients 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.ResultsAmong 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.ConclusionsAmong 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 materialThe online version of this article (doi:10.1186/s12931-017-0587-9) contains supplementary material, which is available to authorized users.

show abstract

“…A recent study suggested that greater reversibility of airflow limitation at baseline was associated with better long-term outcomes in COPD patients without significant comorbidities. 39 Chronic inflammation in bronchiectasis leads to bronchomalacia or excessive collapsibility, resulting in obstructive airway physiology. 40 , 41 However, few studies have investigated the association between bronchiectasis and BDR in moderate-to-severe COPD patients.…”

Section: Discussionmentioning

confidence: 99%

Quantitative computed tomography features and clinical manifestations associated with the extent of bronchiectasis in patients with moderate-to-severe COPD

Bak¹,

Kim²,

Hong³

et al. 2018

COPD

View full text Add to dashboard Cite

BackgroundFew studies have investigated the quantitative computed tomography (CT) features associated with the severity of bronchiectasis in COPD patients. The purpose of this study was to identify the quantitative CT features and clinical values to determine the extent of bronchiectasis in moderate-to-severe COPD patients.MethodsA total of 127 moderate-to-severe COPD patients were selected from the cohort of COPD in Dusty Areas (CODA). The study subjects were classified into three groups according to the extent of bronchiectasis on CT: no bronchiectasis, mild bronchiectasis, and moderate-to-severe bronchiectasis. The three groups were compared with respect to demographic data, symptoms, medical history, serum inflammatory markers, pulmonary function, and quantitative CT values.ResultsAmong 127 moderate-to-severe COPD subjects, 73 patients (57.5%) were detected to have bronchiectasis, 51 patients (40.2%) to have mild bronchiectasis, and 22 patients (17.3%) to have moderate-to-severe bronchiectasis. Compared with COPD patients without bronchiectasis, those with bronchiectasis were older and had higher frequency of prior tuberculosis, lower prevalence of bronchodilator reversibility (BDR), and more severe air trapping (P < 0.05). Moderate-to-severe bronchiectasis patients had lower body mass index (BMI), higher frequency of prior tuberculosis, lower prevalence of BDR, worse pulmonary function, and more severe air trapping (P < 0.05) than those in the mild bronchiectasis group.ConclusionModerate-to-severe bronchiectasis was associated with a history of pulmonary tuberculosis, lower BMI, severe airflow obstruction, and lower BDR in moderate-to-severe COPD patients. Quantitative analysis of CT showed that severe air trapping was associated with the extent of bronchiectasis in these patients.

show abstract

Airflow reversibility and long-term outcomes in patients with COPD without comorbidities

Abstract: In a large population of well characterized COPD patients without significant comorbidities, those demonstrating higher levels of reversibility at baseline presented better long-term outcomes even after controlling for other known prognostic factors.

Cited by 18 publications

References 38 publications

COPD phenotypes: differences in survival

COPD phenotypes: differences in survival

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

Quantitative computed tomography features and clinical manifestations associated with the extent of bronchiectasis in patients with moderate-to-severe COPD

Contact Info

Product

Resources

About