Impact of baseline symptoms and health status on COPD exacerbations in the FLAME study

Mackay, Alexander; Κostikas, Κonstantinos; Roche, Nicolás; Frent, Stefan; Olsson, Petter; Pfister, Pascal; Gupta, Pritam; Patalano, Francesco; Banerji, Donald; Wedzicha, Jadwiga A.

doi:10.1186/s12931-020-01354-8

Cited by 12 publications

(7 citation statements)

References 37 publications

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“…19,20 The frequency of AECOPD events has previously been tied to a decline in patient-reported quality of life, though over longer durations 7,9,21,22 as time from recovery to baseline from an index exacerbation is estimated at 91 days. 23 These events are associated with low baseline patient-reported quality of life and lung function, 24,25,26 as our study corroborates, and associated with the development of a frequent-exacerbator phenotype. 27,28 One prior study reports similar findings, including the contrast between improvement in patients without exacerbations compared to a stepwise worsening in patients with an increasing frequency of exacerbations, but like other trials, this was observed over at least 52 weeks.…”

Section: Resultssupporting

confidence: 78%

Short-Term Impact of the Frequency of COPD Exacerbations on Quality of Life

Camac¹,

Stumpf²,

Voelker³

et al. 2022

J COPD F

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Section: Resultssupporting

confidence: 78%

Short-Term Impact of the Frequency of COPD Exacerbations on Quality of Life

Camac¹,

Stumpf²,

Voelker³

et al. 2022

J COPD F

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“…However, further studies have since been published that further support the prognostic factors identified here. For example, recent studies have reported an increased risk of exacerbations in patients with a history of exacerbations [ 105 ], comorbidities [ 106 ], poorer lung function (GOLD stage) [ 105 ], higher symptomatic burden [ 107 ], female sex [ 105 ], and lower BMI [ 106 , 108 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic risk factors for moderate-to-severe exacerbations in patients with chronic obstructive pulmonary disease: a systematic literature review

et al. 2022

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Background Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD exacerbations are associated with a worsening of lung function, increased disease burden, and mortality, and, therefore, preventing their occurrence is an important goal of COPD management. This review was conducted to identify the evidence base regarding risk factors and predictors of moderate-to-severe exacerbations in patients with COPD. Methods A literature review was performed in Embase, MEDLINE, MEDLINE In-Process, and the Cochrane Central Register of Controlled Trials (CENTRAL). Searches were conducted from January 2015 to July 2019. Eligible publications were peer-reviewed journal articles, published in English, that reported risk factors or predictors for the occurrence of moderate-to-severe exacerbations in adults age ≥ 40 years with a diagnosis of COPD. Results The literature review identified 5112 references, of which 113 publications (reporting results for 76 studies) met the eligibility criteria and were included in the review. Among the 76 studies included, 61 were observational and 15 were randomized controlled clinical trials. Exacerbation history was the strongest predictor of future exacerbations, with 34 studies reporting a significant association between history of exacerbations and risk of future moderate or severe exacerbations. Other significant risk factors identified in multiple studies included disease severity or bronchodilator reversibility (39 studies), comorbidities (34 studies), higher symptom burden (17 studies), and higher blood eosinophil count (16 studies). Conclusions This systematic literature review identified several demographic and clinical characteristics that predict the future risk of COPD exacerbations. Prior exacerbation history was confirmed as the most important predictor of future exacerbations. These prognostic factors may help clinicians identify patients at high risk of exacerbations, which are a major driver of the global burden of COPD, including morbidity and mortality.

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“…Several studies have reported that the increased CAT score is associated with dyspnea 28,29 and acute exacerbation state or its future risk. [11][12][13][29][30][31] Whilst it is known that FEV 1 has a weak correlation with CAT score, 12,28 several studies have shown a correlation between total CAT scores and GOLD grades. 12,29 In our study, we also found a correlation between total CAT scores and the degree of airflow limitation and DLco.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of COPD Patients According to COPD Assessment Test (CAT) Score Level: Cross-Sectional Study

Gil¹,

Zo²,

Jones³

et al. 2021

COPD

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Purpose The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is widely used to assess the impact of COPD symptoms on health status. Whilst the CAT consists of eight different items, details on the distribution of each item are limited. This study aimed to investigate the distribution and clinical implication of each CAT item, stratified by CAT severity group, in stable COPD patients. Patients and Methods This was a cross-sectional study at a single referral hospital in South Korea. Spirometry confirmed COPD patients with CAT measured at the first clinical visit were retrospectively identified. Patients were categorized into three groups: low (0 ≤ CAT < 10), medium (10 ≤ CAT < 20), and high (20 ≤ CAT ≤ 40) impact group. For the purpose of this analysis, the first four items (cough, sputum, chest tightness, and dyspnea) and the remaining four items (activities, confidence, sleep and energy) were also grouped as “pulmonary” and “extra-pulmonary”, respectively. Results A total of 815 patients were included, and mean (SD) forced expiratory volume in 1 s (FEV 1 ) was 62.8 (17.4) % pred. Among them, 300 patients (36.8%) were in the high impact group and had a greater exacerbation history and lower lung function. The proportion of “extra-pulmonary” items score was greater in patients with higher total CAT scores, with the activity and confidence items showing higher scores. Conclusion In our study, in addition to dyspnea, activity limitation is a particular problem in individual patients with higher CAT total scores, for which physicians need to pay more attention. Our study suggests that whilst CAT total score captures the overall impact of COPD, each item of the CAT contains potentially useful information in understanding the patient’s symptom burden.

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Impact of baseline symptoms and health status on COPD exacerbations in the FLAME study

Cited by 12 publications

References 37 publications

Short-Term Impact of the Frequency of COPD Exacerbations on Quality of Life

Short-Term Impact of the Frequency of COPD Exacerbations on Quality of Life

Prognostic risk factors for moderate-to-severe exacerbations in patients with chronic obstructive pulmonary disease: a systematic literature review

Clinical Characteristics of COPD Patients According to COPD Assessment Test (CAT) Score Level: Cross-Sectional Study

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