Background

Understanding the risk factors for exacerbations of COPD may help provide a more personalised approach to exacerbation prevention.

Method

Observational, prospective, international, multicentre study aimed at identifying risk factors for exacerbations of COPD. Clinical variables, lung function and CAT scores were collected at baseline. In addition, routine blood biomarkers were also obtained, and patients were followed for 12 months.

Results

A total of 326 patients were included. Of these, 155 (47.5%) presented at least one exacerbation. The median time to the first exacerbation was 147 days. Exacerbators had more respiratory symptoms, more impairment in FEV1(%), FVC(%) and a worse CAT score. Regarding biomarkers, only C-reactive protein was significantly higher in exacerbators (2.8 (standard deviation (SD):3.8) mg/dL vs. 1.9 (SD:2.6) mg/dL; p = 0.037). In multivariate analysis, only CAT scores, FEV1(%) and previous exacerbations were significantly associated with having an exacerbation during follow-up. In the equation of risk, patients with a CAT score ≥15, FEV1(%) <55% and at least one exacerbation the previous year had a probability of 76% of having an exacerbation during the next year, compared with 17% in patients who had none of the previous variables. No biomarkers showed a significant association in multivariate analysis.

Conclusions

Less than half of the patients presented an exacerbation during the one-year follow-up. CAT scores, FEV1(%) and previous exacerbations were the only variables associated with increased risk of exacerbations. Routine biomarkers did not provide additional information to evaluate the risk of exacerbations.

中文翻译：

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与常规血液生物标志物相比，临床和肺活量测定变量是COPD恶化的更好预测指标。

背景

了解COPD病情加重的危险因素可能有助于提供更个性化的预防病情加重的方法。

方法

一项观察性，前瞻性，国际性，多中心研究，旨在确定COPD病情加重的危险因素。在基线时收集临床变量，肺功能和CAT评分。此外，还获得了常规血液生物标志物，并对患者进行了12个月的随访。

结果

总共包括326名患者。其中155例（47.5％）表现出至少一种病情加重。首次发作的中位时间为147天。加重者有更多的呼吸道症状，FEV1（％），FVC（％）受损更多，CAT评分更差。关于生物标志物，加重剂中仅C反应蛋白显着较高（2.8（标准差（SD）：3.8）mg / dL，而1.9（SD：2.6）mg / dL； p = 0.037）。在多变量分析中，只有CAT评分，FEV1（％）和以前的发作与随访期间的发作显着相关。在风险方程中，CAT得分≥15，FEV1（％）<55％且前一年至少发作一次的患者在下一年发作的可能性为76％，而患者为17％谁没有以前的变量。

结论

在一年的随访中，不到一半的患者病情加重。CAT评分，FEV1（％）和先前加重是与加重风险增加相关的唯一变量。常规生物标志物未提供其他信息来评估病情加重的风险。