Hospitalized exacerbations of COPD

Risk factors and outcomes in the ECLIPSE cohort

ECLIPSE Investigators

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N=2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history ofexacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airfl ow limitation, poorer health status, older age, radiologic evidence ofemphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P , <001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airfl ow limitation and are a significant prognostic factor ofreduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airfl ow limitation, poor health status, age, presence ofemphysema, and leukocytosis.

Original languageEnglish (US)
Pages (from-to)999-1007
Number of pages9
JournalChest
Volume147
Issue number4
DOIs
StatePublished - Apr 1 2015

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Chronic Obstructive Pulmonary Disease
Biomarkers
Health Status
Hospitalization
Mortality
Leukocytosis
Recurrence
Survival
Incidence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Hospitalized exacerbations of COPD : Risk factors and outcomes in the ECLIPSE cohort. / ECLIPSE Investigators.

In: Chest, Vol. 147, No. 4, 01.04.2015, p. 999-1007.

Research output: Contribution to journalArticle

ECLIPSE Investigators. / Hospitalized exacerbations of COPD : Risk factors and outcomes in the ECLIPSE cohort. In: Chest. 2015 ; Vol. 147, No. 4. pp. 999-1007.
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abstract = "OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N=2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31{\%}) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15{\%}) reported multiple events. A prior history ofexacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95{\%} CI, 2.24-3.29; P <.001). Other risk factors included more severe airfl ow limitation, poorer health status, older age, radiologic evidence ofemphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P , <001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airfl ow limitation and are a significant prognostic factor ofreduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airfl ow limitation, poor health status, age, presence ofemphysema, and leukocytosis.",
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T1 - Hospitalized exacerbations of COPD

T2 - Risk factors and outcomes in the ECLIPSE cohort

AU - ECLIPSE Investigators

AU - Müllerova, Hana

AU - Maselli, Diego J.

AU - Locantore, Nicholas

AU - Vestbo, Jørgen

AU - Hurst, John R.

AU - Wedzicha, Jadwiga A.

AU - Bakke, Per

AU - Agusti, Alvar

AU - Anzueto, Antonio

AU - Ivanov, Yavor

AU - Kostov, Kosta

AU - Bourbeau, Jean

AU - Fitzgerald, Mark

AU - Hernández, Paul

AU - Killian, Kieran

AU - Levy, Robert

AU - Maltais, Francois

AU - O'Donnell, Denis

AU - Krepelka, Jan

AU - Wouters, Emiel F M

AU - Quinn, Dean

AU - Kosnik, Mitja

AU - Feschenko, Yuri

AU - Gavrisyuk, Volodymyr

AU - Yashina, Lyudmila

AU - MacNee, William

AU - Singh, S. David

AU - Braman, Sidney

AU - Casaburi, Richard

AU - Celli, Bart

AU - Giessel, Glenn

AU - Gotfried, Mark

AU - Greenwald, Gary

AU - Hanania, Nicola

AU - Mahler, Don

AU - Make, Barry

AU - Rennard, Stephen

AU - Rochester, Carolyn

AU - Scanlon, Paul D

AU - Schuller, Dan

AU - Sciurba, Frank

AU - Sharafkhaneh, Amir

AU - Siler, Thomas

AU - Silverman, Edwin

AU - Wanner, Adam

AU - Wise, Robert

AU - Wallack, Richard Zu

PY - 2015/4/1

Y1 - 2015/4/1

N2 - OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N=2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history ofexacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airfl ow limitation, poorer health status, older age, radiologic evidence ofemphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P , <001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airfl ow limitation and are a significant prognostic factor ofreduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airfl ow limitation, poor health status, age, presence ofemphysema, and leukocytosis.

AB - OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N=2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history ofexacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airfl ow limitation, poorer health status, older age, radiologic evidence ofemphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P , <001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airfl ow limitation and are a significant prognostic factor ofreduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airfl ow limitation, poor health status, age, presence ofemphysema, and leukocytosis.

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DO - 10.1378/chest.14-0655

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JO - Chest

JF - Chest

SN - 0012-3692

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