Researchers Find 3 Determinants of Frequent COPD Exacerbations

A history of exacerbations, anxiety, and not having received the annual influenza vaccine are the most important determinants of frequent exacerbations among patients with chronic obstructive pulmonary disease (COPD), according to a new study analysis.

To reach this conclusion, the researchers analyzed data on 932 patients with COPD, 446 of whom with complete data had been followed over a 3-year period. Of those 446 patients, 65.68% were men, and 35.59% were current smokers.

In all, 239 (28.15%) patients had had experienced frequent exacerbations, having reported at least 2 exacerbations in the year prior to enrollment. During the first year of the study, 142 (16.68%) patients had frequent exacerbations. And in the second year of the study, 69 (8.10%) of those patients had continued to experience frequent exacerbations.

Based on their hypothesis that vaccination status and comorbidities could be associated with the occurrence of exacerbations profile, the researchers determined 4 phenotypes: A (infrequent), B (frequent in patients with underweight), C (transient), and D (frequent in patients with obesity).

Those who experienced frequent exacerbations had more airflow limitation and symptoms.

“Irrespective of cut-offs set to define the optimal number of clusters, a history of exacerbations (OR: 3.72[2.53–5.49]), presence of anxiety (OR: 2.03[1.24–3.31]), and absence of the annual influenza vaccination (OR: 1.97[1.20–3.24]) remained associated with the frequent exacerbator phenotypes,” the researchers wrote.

—Colleen Murphy

Reference:

Ouaalaya EH, Falque L, Dupis JM, et al. Susceptibility to frequent exacerbation in COPD patients: impact of the exacerbations history, vaccinations and comorbidities? Respir Med. 2020;169:106018. doi:10.1016/j.rmed.2020.106018