Susceptibility to frequent exacerbation in COPD patients: Impact of the exacerbations history, vaccinations and comorbidities?

Ouaalaya, E.H.; Falque, Laurent; Dupis, Jean Michel; Sabatini, Marielle; Bernady, A.; Nguyen, Laurent; Ozier, A.; Nocent-Ejnaini, C.; Guillou, F. Le; Molimard, Mathiéu; Zysman, M.; Raherison‐Semjen, Chantal

doi:10.1016/j.rmed.2020.106018

Cited by 9 publications

(8 citation statements)

References 37 publications

(42 reference statements)

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“…Comorbidity profile in COPD precisely makes them susceptible to frequent exacerbation. 15 Previous research found that comorbidities seemed to develop at an earlier age and there was a higher prevalence in population with COPD when compared with general population. 16 In elder patients with COPD, inhaler techniques, adherence, respiratory comorbidities and even psychologic disorder (cognitive impairment) should be regarded as predictive tools for clinical risk 17 .…”

Section: Discussionmentioning

confidence: 98%

Distribution of COPD Comorbidities and Creation of Acute Exacerbation Risk Score: Results from SCICP

Ge¹,

Liu²,

Gu³

et al. 2021

JIR

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Background: Chronic obstructive pulmonary disease (COPD) often coexists with multiple comorbidities which may have a significant impact on acute exacerbations of patients. At present, what kind of comorbidities affects acute exacerbations and how comorbidities lead to poor prognosis are still controversial. The purpose of our study is to determine the impact of comorbidities on COPD exacerbation and establish an acute exacerbation risk assessment system related to comorbidities. Methods: A total of 742 COPD patients participated in the Shanghai COPD Investigation on Comorbidity Program (SCICP, ChiCTR2000030911). Finally, the baseline information of 415 participants and one-year follow-up data were involved in the analysis. We collected hemogram indices, pulmonary function tests and acute exacerbation of COPD with regular medical follow-up. Q-type cluster analysis was used to determine the clusters of participants. Receiver operating characteristic (ROC) analysis was constructed to assess the ability of indicators in predicting acute exacerbations. Results: Almost 65% of the population we investigated had at least one comorbidity. The distribution and incidence of comorbidities differed between exacerbation group and nonexacerbation group. Three comorbidity clusters were identified: (1) respiratory, metabolic, immune and psychologic disease (non-severe cases); (2) cardiovascular and neoplastic disease (severe cases); (3) less comorbidity. Different sub-phenotypes of COPD patients showed significant distinction in health status. Anxiety (OR=5.936, P=0.001), angina (OR=10.155, P=0.025) and hypertension (OR=3.142, P=0.001) were found to be independent risk factors of exacerbation in a year. The novel risk score containing BODEx and four diseases showed great prognostic value of COPD exacerbation in developing sample. Conclusion:Our study detailed the major interaction between comorbidities and exacerbation in COPD. Noteworthily, a novel risk score using comprehensive index -BODEx -and comorbidity parameters can identify patients at high risk of acute exacerbation.

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Section: Discussionmentioning

confidence: 98%

Distribution of COPD Comorbidities and Creation of Acute Exacerbation Risk Score: Results from SCICP

Ge¹,

Liu²,

Gu³

et al. 2021

JIR

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“…Although the most frequent viruses associated with exacerbation are human rhinoviruses ( 8 ), influenza is also important, accounting for up to 28% of COPD exacerbations ( 10 ). Influenza can lead to hospitalization, frequent exacerbation, and even death in patients with COPD ( 11 , 12 ). The disease course of influenza is worse in patients with COPD compared with those without COPD.…”

Section: Introductionmentioning

confidence: 99%

Trends in Influenza Vaccination Rates in Participants With Airflow Limitation: The Korea National Health and Nutrition Examination Survey 2007–2018

Lee

Choi

2022

Front. Med.

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BackgroundInfluenza vaccination is strongly recommended for people with chronic lung diseases, including chronic obstructive pulmonary disease, to reduce risk of exacerbation. We assess the influenza vaccination rate and its related factors in participants with airflow limitation (AFL) using nationally representative data in Korea.MethodsWe conducted a cross-sectional study from the Korea National Health and Nutrition Examination Survey from 2007 to 2018. Individuals ≥ 40 years who underwent spirometry and had identifiable information on influenza vaccination status were included.ResultsOverall influenza vaccination coverage was 61.2% in participants with AFL and 41.8% in participants without AFL. Age had a significant impact on the yearly vaccination rate in participants with AFL. Over the 10 years of study period, while the yearly vaccination rate steadily increased from 58.3 to 61.9% in elderly participants (≥65 years) with AFL (p for trend = 0.117), the yearly vaccination rate decreased from 41.5% to 30.8% in younger participants (<65 years) (p for trend = 0.038). In multivariable analyses, younger age [adjusted odds ratio (OR) for unvaccinated = 0.88, 95% confidence interval (CI) = 0.87–0.90], male (adjusted OR = 1.64; 95% CI = 1.23–2.19), and current smokers (adjusted OR = 1.42, 95% CI = 1.01–2.00) were associated with increased odds of being unvaccinated.ConclusionsThe vaccination rate in participants with AFL affected by age. Younger age, male sex, and current smoking were associated with unvaccinated status. More attention and targeted interventions are required to improve the influenza vaccination rate in those with AFL.

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“…30 Other authors, however, have reported a higher risk of AECOPD in patients with anxiety. 31 The differences in results across studies could be related to the heterogeneity of the populations studied and the variability in the de nition of COPD (changes in symptoms and treatment, inclusion of outpatients versus inpatients, comorbidities considered...), as well as the various methods used for the evaluation of anxiety and depression.…”

Section: Discussionmentioning

confidence: 99%

Impact of Anxiety and Depression on The Prognosis of COPD Exacerbations

Martínez-Gestoso¹,

García-Sanz

Carreira

et al. 2022

Preprint

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Background: Frequent and highly prevalent as comorbidities in Chronic obstructive pulmonary disease (COPD) patients, both depression and anxiety seem to have an impact on COPD prognosis. However, they are underdiagnosed and rarely treated properly. Aim: to establish the prevalence of depression and anxiety in patients admitted for acute exacerbation of COPD (AECOPD) and determine their influence on COPD prognosis.Methods: Prospective observational study conducted from October 1, 2016 to October 1, 2018 at the following centers in Galicia, Spain: Salnés County Hospital, Arquitecto Marcide, and Clinic Hospital Complex of Santiago de Compostela. Patients admitted for AECOPD who agreed to participate and completed the anxiety and depression scale (HADS) were included in the study.Results: 288 patients (46.8%) were included, mean age was 73.7 years (SD 10.9), 84.7% were male. 67.7% patients were diagnosed with probable depression, and depression was established in 41.7%; anxiety was probable in 68.2% and established in 35.4%. 60.4% of all patients showed symptoms of both anxiety and depression. Multivariate analysis relates established depression with a higher risk of late readmission (OR 2.06, 95% CI 1.28; 3.31) and a lower risk of mortality at 18 months (OR 0.57, 95% CI 0.37;0.90) Conclusion: the prevalence of anxiety and depression in COPD patients is high. Depression seems to be an independent factor for AECOPD, so early detection and a multidisciplinary approach could improve the prognosis of both entities.The study was approved by the Ethical Committee of Galicia (code 2016/460).

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Susceptibility to frequent exacerbation in COPD patients: Impact of the exacerbations history, vaccinations and comorbidities?

Cited by 9 publications

References 37 publications

Distribution of COPD Comorbidities and Creation of Acute Exacerbation Risk Score: Results from SCICP

Distribution of COPD Comorbidities and Creation of Acute Exacerbation Risk Score: Results from SCICP

Trends in Influenza Vaccination Rates in Participants With Airflow Limitation: The Korea National Health and Nutrition Examination Survey 2007–2018

Impact of Anxiety and Depression on The Prognosis of COPD Exacerbations

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