Clinical and Functional Lung Parameters Associated With Frequent Exacerbator Phenotype in Subjects With Severe COPD.

BACKGROUND: COPD is currently recognized as a syndrome associated with a high prevalence of comorbidities and various phenotypes. Exacerbations are very important events in the clinical history of COPD because they drive the decline in lung function. In the present study, we aim to identify whether...

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Publicado en:Respiratory Care Vol. 62; no. 5; pp. 572 - 579
Autores principales: Capozzolo, Alberto, Carratù, Pierluigi, Dragonieri, Silvano, Falcone, Vito Antonio, Quaranta, Vitaliano Nicola, Liotino, Vito, D'Alba, Giuseppina, Castellana, Giorgio, Resta, Onofrio
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. May2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Clinical and Functional Lung Parameters Associated With Frequent Exacerbator Phenotype in Subjects With Severe COPD.
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        au:
          Capozzolo, Alberto
          Carratù, Pierluigi
          Dragonieri, Silvano
          Falcone, Vito Antonio
          Quaranta, Vitaliano Nicola
          Liotino, Vito
          D'Alba, Giuseppina
          Castellana, Giorgio
          Resta, Onofrio
        affil: Institute of Respiratory Disease, Department of Cardiac, Thoracic, and Vascular Science, University of Medicine, Bari, Italy
      sug:
        subj:
          Pulmonary Disease, Chronic Obstructive Complications
          Lung
          Disease Exacerbation
          Phenotype
          Human
          Descriptive Statistics
          Cross Sectional Studies
          Case Control Studies
          Pulmonary Disease, Chronic Obstructive Classification
          Inspiration, Respiratory
          Scales
          Lung Volume Measurements
          Severity of Illness
          Italy
          Respiratory Function Tests
          Spirometry
          Total Lung Capacity
          Vital Capacity
          Forced Expiratory Volume
          P-Value
          T-Tests
          Mann-Whitney U Test
          Fisher's Exact Test
          Chi Square Test
          Multiple Logistic Regression
          Spearman's Rank Correlation Coefficient
          Male
          Female
          Aged
          Middle Age
          Odds Ratio
          Confidence Intervals
          Pulmonary Disease, Chronic Obstructive Drug Therapy
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: COPD is currently recognized as a syndrome associated with a high prevalence of comorbidities and various phenotypes. Exacerbations are very important events in the clinical history of COPD because they drive the decline in lung function. In the present study, we aim to identify whether there are any clinical and functional specific features of frequent exacerbators in a population of patients with severe COPD. METHODS: We conducted a cross-sectional, case control study. All subjects had Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3 or 4 COPD (FEV1 < 50% predicted). Frequent exacerbators (n = 183) reported ≥2 exacerbations or ≥1 determining hospitalization during the previous 12 months, and infrequent exacerbators (n = 162) reported <2 exacerbations over the last 12 months without hospitalization. Multivariate logistic regression was performed to determine the clinical and functional factors significantly associated with frequent exacerbator status. RESULTS: Frequent exacerbators had a significantly lower inspiratory capacity percentage predicted. The Motley index (residual volume/total lung capacity percentage) was significantly increased in frequent exacerbators. Infrequent exacerbators had lower Modified Medical Research Council dyspnea scale and BODE index than frequent exacerbators. In the multivariate model, a reduced inspiratory capacity percentage predicted and an increase of residual volume/total lung capacity percentage, BODE index and Modified Medical Research Council dyspnea scale were associated with the frequent exacerbation phenotype. CONCLUSIONS: Static hyperinflation and respiratory disability, measured by Motley index and Modified Medical Research Council dyspnea scale, respectively, in the same way as the multidimensional BODE index staging system, were independently associated with frequent exacerbation status in subjects with severe COPD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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