Burden of Exacerbations in Patients with Moderate to Very Severe COPD in the Netherlands: A Real-life Study

Overbeek, Jetty A.; Beest, Fernie J. A. Penning-van; Balp, Maria‐Magdalena; Dekhuijzen, P.N.R.; Herings, Ron M. C.

doi:10.3109/15412555.2014.898053

Cited by 12 publications

(13 citation statements)

References 25 publications

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“…Patients with severe and very severe COPD at screening had a higher incidence of exacerbations during the study than patients with moderate COPD, with exacerbation incidence rates ranging from under one per year (moderate, GOLD grade 2) to almost two per year (very severe, GOLD grade 4). A similar trend, but with lower AECOPD incidence rates, was reported in a retrospective analysis of 886 patients with COPD in the Netherlands, in which exacerbation incidence rates were two-fold higher in patients with very severe COPD than in those with moderate COPD [30]. We also found evidence of worsening general health status during the study that was more pronounced in patients experiencing more frequent exacerbations.…”

Section: Discussionsupporting

confidence: 88%

Airway pathogens detected in stable and exacerbated COPD in patients in Asia-Pacific

Taddei¹,

Malvisi²,

Hui

et al. 2022

ERJ Open Res

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BackgroundThe burden of COPD in the Asia-Pacific region is projected to increase. Data from other regions show bacterial and viral infections can trigger acute exacerbations of COPD (AECOPD).MethodsThis 1-year, prospective, epidemiological study (NCT03151395) of patients with moderate to very severe COPD in Hong Kong, the Philippines, South Korea and Taiwan assessed the prevalence in sputum samples (by culture and PCR) of bacterial and viral pathogens during stable COPD and AECOPD. The odds of experiencing an exacerbation was evaluated for pathogen presence, acquisition and apparition. Health-related quality of life (HRQOL) was assessed.Results197 patients provided 983 sputum samples; 226 during exacerbation episodes. The mean yearly AECOPD incidence rate was 1.27 per patient. The most prevalent bacteria by PCR at exacerbation were Haemophilus influenzae (Hi) and Moraxella catarrhalis (Mcat); Mcat prevalence was higher at exacerbation than at stable-state. Virus prevalence was low, other than for human rhinovirus (HRV: 8.1%, stable-state; 16.6%, exacerbation). The odds ratio for an exacerbation (versus stable state) was statistically significant for presence, acquisition and apparition of Hi (2.20 [95% CI: 1.26–3.89]; 2.43 [1.11–5.35]; 2.32 [1.20–4.46], respectively), Mcat (2.24 [1.30–3.88]; 5.47 [2.16–13.86]; 3.45 [1.71–6.98], respectively) and HRV (2.12 [1.15–3.91]; 2.22 [1.09–4.54]; 2.09 [1.11–3.91], respectively). HRQOL deteriorated according to number of exacerbations experienced.ConclusionIn patients with COPD in the Asia-Pacific region, the presence of Hi, Mcat or HRV in sputum samples significantly increased the odds of an exacerbation, providing further evidence of potential roles in triggering AECOPD.

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Section: Discussionsupporting

confidence: 88%

Airway pathogens detected in stable and exacerbated COPD in patients in Asia-Pacific

Taddei¹,

Malvisi²,

Hui

et al. 2022

ERJ Open Res

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“… 17 , 18 Similar to other complex clinical conditions that need strict monitoring post discharge (such as congestive heart failure), 17 , 18 there is a strong interest in identifying which clinical factors increase the risk of relapse in COPD patients, given the high impact of readmissions. 19 , 20 …”

Section: Introductionmentioning

confidence: 99%

Acute exacerbations of COPD: risk factors for failure and relapse

Mantero¹,

Rogliani²,

Pasquale³

et al. 2017

COPD

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Acute exacerbations are a leading cause of worsening COPD in terms of lung function decline, quality of life, and survival. They also have a relevant economic burden on the health care system. Determining the risk factors for acute exacerbation and early relapse could be a crucial element for a better management of COPD patients. This review analyzes the current knowledge and underlines the main risk factors for recurrent acute exacerbations. Comprehensive evaluation of COPD patients during stable phase and exacerbation could contribute to prevent treatment failure and relapses.

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“…COPD exacerbations are more common in patients with higher severity of airflow limitation, a higher symptom burden and a higher frequency of previous exacerbations. Annual exacerbation rates have been reported to at least double between patients with mild-to-moderate airflow limitation and those with very severe airflow limitation [6,36]. Moreover, in another study, annual exacerbation rates increased 3-fold between patients with a low symptom burden and exacerbation risk and those with a high symptom burden and exacerbation risk [37].…”

Section: Triggersmentioning

confidence: 99%

Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life

Hurst

Skolnik

Hansen

et al. 2020

European Journal of Internal Medicine

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Exacerbations of chronic obstructive pulmonary disease (COPD) represent a significant clinical problem, and are associated with decreased lung function, worsening quality of life and decreased physical activity levels, with even a single exacerbation having detrimental effects. The occurrence of COPD exacerbations can also have a considerable impact on healthcare costs and mortality rates, with over one-fifth of patients hospitalized for a COPD exacerbation for the first time dying within one year of discharge. This highlights the need for COPD exacerbations to be a major focus in clinical practice. Furthermore, the substantial effect that COPD exacerbations can have on patient mental health should not be underestimated. Despite their clinical importance, COPD exacerbations are poorly recognized and reported by patients, and improving patient understanding and reporting of exacerbations to ensure prompt treatment may minimize their deleterious effects. Renewed focus on improving current clinical practice with support from evidence-based guidelines is required. This also raises a challenge to payors, healthcare systems and government policies to do more to tackle the considerable outstanding burden of COPD exacerbations. Search methodsRelevant articles for this non-systematic, narrative literature review were identified via PubMed searches and from author knowledge. Only articles published in English were included.

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Burden of Exacerbations in Patients with Moderate to Very Severe COPD in the Netherlands: A Real-life Study

Abstract: AECOPD recurrence rates and healthcare utilization are significantly higher among patients with more severe COPD.

Cited by 12 publications

References 25 publications

Airway pathogens detected in stable and exacerbated COPD in patients in Asia-Pacific

Airway pathogens detected in stable and exacerbated COPD in patients in Asia-Pacific

Acute exacerbations of COPD: risk factors for failure and relapse

Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life

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