Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?
Abstract Background It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute ex...
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BMC
2017-05-01
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Series: | Respiratory Research |
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Online Access: | http://link.springer.com/article/10.1186/s12931-017-0587-9 |
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doaj-02e52fd0c2994b2daf4747a9be35c132 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Junghyun Kim Woo Jin Kim Chang-Hoon Lee Sang Haak Lee Myung-Goo Lee Kyeong-Cheol Shin Kwang Ha Yoo Ji-Hyun Lee Seong Yong Lim Ju Ock Na Hun-Gyu Hwang Yoonki Hong Myoung Nam Lim Chul-Gyu Yoo Ki Suck Jung Sang-Do Lee |
spellingShingle |
Junghyun Kim Woo Jin Kim Chang-Hoon Lee Sang Haak Lee Myung-Goo Lee Kyeong-Cheol Shin Kwang Ha Yoo Ji-Hyun Lee Seong Yong Lim Ju Ock Na Hun-Gyu Hwang Yoonki Hong Myoung Nam Lim Chul-Gyu Yoo Ki Suck Jung Sang-Do Lee Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? Respiratory Research Bronchodilator reversibility COPD Severe acute exacerbation |
author_facet |
Junghyun Kim Woo Jin Kim Chang-Hoon Lee Sang Haak Lee Myung-Goo Lee Kyeong-Cheol Shin Kwang Ha Yoo Ji-Hyun Lee Seong Yong Lim Ju Ock Na Hun-Gyu Hwang Yoonki Hong Myoung Nam Lim Chul-Gyu Yoo Ki Suck Jung Sang-Do Lee |
author_sort |
Junghyun Kim |
title |
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
title_short |
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
title_full |
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
title_fullStr |
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
title_full_unstemmed |
Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
title_sort |
which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients? |
publisher |
BMC |
series |
Respiratory Research |
issn |
1465-993X |
publishDate |
2017-05-01 |
description |
Abstract Background It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients. Methods Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study. The assessed BDR criteria included the Global Initiative for Chronic Obstructive Lung Disease (GOLD), American Thoracic Society (ATS), American College of Chest Physicians, (ACCP), major criteria of the Spanish definition of asthma-COPD overlap syndrome (ACOS), criteria compatible with ACOS in the Global Initiative for Asthma (GINA), and European Respiratory Society (ERS). The rate of patients with severe AE who required hospitalization within 1 year due to BDR results according to each set of criteria was analyzed using logistic regression models. Results Among a total of 854 patients, the BDR-positive cases varied according to the criteria used. There was a 3.5% positive BDR rate according to GINA and a 29.9% rate according to the ATS criteria. Positive BDR according to the GOLD criteria was significantly associated with a decreased risk of severe AE (adjusted odds ratio (aOR) = 0.38; 95% Confidence interval (CI) = 0.15–0.93). This result remained statistically significant even in a sensitivity analysis that included only participants with a smoking history of at least 10 pack-years and in the analysis for the propensity score-matched participants. Conclusions Among different criteria for positive BDR, the use of the GOLD ones was significantly associated with a decreased risk of severe AE in COPD patients. Increase use of ICS/LABA may have affected this relationship. |
topic |
Bronchodilator reversibility COPD Severe acute exacerbation |
url |
http://link.springer.com/article/10.1186/s12931-017-0587-9 |
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doaj-02e52fd0c2994b2daf4747a9be35c1322020-11-24T21:25:19ZengBMCRespiratory Research1465-993X2017-05-011811910.1186/s12931-017-0587-9Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?Junghyun Kim0Woo Jin Kim1Chang-Hoon Lee2Sang Haak Lee3Myung-Goo Lee4Kyeong-Cheol Shin5Kwang Ha Yoo6Ji-Hyun Lee7Seong Yong Lim8Ju Ock Na9Hun-Gyu Hwang10Yoonki Hong11Myoung Nam Lim12Chul-Gyu Yoo13Ki Suck Jung14Sang-Do Lee15Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical CenterDepartment of Internal Medicine and Environmental Health Center, Kangwon National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, The Catholic University of Korea, St. Paul’s HospitalDivision of Pulmonary, Allergy & Critical Care Medicine, Hallym University Chuncheon Sacred Heart HospitalDivision of Pulmonology and Allergy, Regional Center for Respiratory Disease, Yeungnam University Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of MedicineDivision of Respiratory and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA UniversityDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Pulmonary Medicine, Soonchunhyang University Cheonan HospitalDepartment of Medicine, Soonchunhyang University Gumi’s HospitalDepartment of Internal Medicine and Environmental Health Center, Kangwon National University HospitalDepartment of Internal Medicine and Environmental Health Center, Kangwon National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University HospitalDivision of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical SchoolDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineAbstract Background It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients. Methods Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study. The assessed BDR criteria included the Global Initiative for Chronic Obstructive Lung Disease (GOLD), American Thoracic Society (ATS), American College of Chest Physicians, (ACCP), major criteria of the Spanish definition of asthma-COPD overlap syndrome (ACOS), criteria compatible with ACOS in the Global Initiative for Asthma (GINA), and European Respiratory Society (ERS). The rate of patients with severe AE who required hospitalization within 1 year due to BDR results according to each set of criteria was analyzed using logistic regression models. Results Among a total of 854 patients, the BDR-positive cases varied according to the criteria used. There was a 3.5% positive BDR rate according to GINA and a 29.9% rate according to the ATS criteria. Positive BDR according to the GOLD criteria was significantly associated with a decreased risk of severe AE (adjusted odds ratio (aOR) = 0.38; 95% Confidence interval (CI) = 0.15–0.93). This result remained statistically significant even in a sensitivity analysis that included only participants with a smoking history of at least 10 pack-years and in the analysis for the propensity score-matched participants. Conclusions Among different criteria for positive BDR, the use of the GOLD ones was significantly associated with a decreased risk of severe AE in COPD patients. Increase use of ICS/LABA may have affected this relationship.http://link.springer.com/article/10.1186/s12931-017-0587-9Bronchodilator reversibilityCOPDSevere acute exacerbation |