Changes in Control Status of COPD Over Time and Their Consequences: A Prospective International Study
Por:
Miravitlles M, Sliwinski P, Rhee CK, Costello RW, Carter V, Tan JHY, Lapperre TS, Alcazar B, Gouder C, Esquinas C, García-Rivero JL, Kemppinen A, Tee A, Roman-Rodríguez M, Soler-Cataluña JJ, Price DB, Respiratory Effectiveness Group (REG) and following investigators participated in the study
Publicada:
1 feb 2021
Ahead of Print:
1 feb 2021
Categoría:
Pulmonary and respiratory medicine
Resumen:
Introduction: Control status may be a useful tool to assess response to treatment at each clinical visit in COPD. Control status has demonstrated to have long-term predictive value for exacerbations, but there is no information about the short-term predictive value of the lack of control and changes in control status over time.
Method: Prospective, international, multicenter study aimed at describing the short-term (6 months) prognostic value of control status in patients with COPD. Patients with COPD were classified as controlled/uncontrolled at baseline and at 3,6-month follow-up visits using previously validated criteria of control. Moderate and severe exacerbation rates were compared between controlled and uncontrolled visits and between patients persistently controlled, uncontrolled and those changing control status over follow-up.
Results: A total of 267 patients were analyzed: 80 (29.8%) were persistently controlled, 43 (16%) persistently uncontrolled and 144 (53.7%) changed control status during follow-up. Persistently controlled patients were more frequently men, with lower (not increased) body mass index and higher FEV1(%). During the 6 months following an uncontrolled patient visit the odds ratio (OR) for presenting a moderate exacerbation was 3.41 (95% confidence interval (CI) 2.47-4.69) and OR = 4.25 (95%CI 2.48-7.27) for hospitalization compared with a controlled patient visit.
Conclusions: Evaluation of control status at each clinical visit provides relevant prognostic information about the risk of exacerbation in the next 6 months. Lack of control is a warning signal that should prompt investigation and action in order to achieve control status. (C) 2020 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Miravitlles M:
Pneumology Department, Hospital Universitari Vall d'Hebron
Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
CIBER de Enfermedades Respiratorias (CIBERES), Spain
Sliwinski P:
2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Rhee CK:
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Costello RW:
Department of Respiratory Medicine, Royal College of Surgeons, Dublin, Ireland
Carter V:
Optimum Patient Care, Cambridge, UK
Tan JHY:
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
Lapperre TS:
Duke-National University of Singapore Medical School, Singapore
Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
Alcazar B:
CIBER de Enfermedades Respiratorias (CIBERES), Spain
Respiratory Department, Hospital de Alta Resolución de Loja, Spain
Gouder C:
Department of Respiratory Medicine, Mater Dei Hospital, Malta
Esquinas C:
Pneumology Department, Hospital Universitari Vall d'Hebron
Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
Public Health, Mental, Maternal and Child Health Nursing Department, Faculty of Medicine and Health Sciences, University of Barcelona, Spain
García-Rivero JL:
Department of Respiratory Medicine, Hospital Comarcal de Laredo, Cantabria, Spain
Kemppinen A:
Optimum Patient Care, Cambridge, UK
Tee A:
Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
Roman-Rodríguez M:
Primary Health-care Center Son Pisà, IB-Salut, Palma, Baleares, Spain
:
CIBER de Enfermedades Respiratorias (CIBERES), Spain
Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain
Price DB:
Centre of Academic Primary Care, University of Aberdeen, UK
Observational and Pragmatic Research Institute, Singapore
Miravitlles M:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Esquinas C:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Barrecheguren M:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Nuñez A:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Alcazar B:
Hospital de Alta Resolución de Loja, Spain
García-Rivero JL:
Hospital Comarcal de Laredo, Cantabria, Spain
Hueso K:
Hospital Comarcal de Laredo, Cantabria, Spain
Roman-Rodríguez M:
Primary Health-care Center Son Pisà, IB-Salut, Palma de Mallorca, Spain
Sliwinski P:
Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Iwan K:
Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Kolakowski J:
Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Rhee CK:
St Mary's Hospital, Seoul, Korea
Ahn E:
St Mary's Hospital, Seoul, Korea
Tan J:
Singapore General Hospital, Singapore
Laperre T:
Singapore General Hospital, Singapore
Leng KTL:
Singapore General Hospital, Singapore
Chia N:
Singapore General Hospital, Singapore
How OT:
Singapore General Hospital, Singapore
Shamsuddin S:
Singapore General Hospital, Singapore
Gim SLS:
Singapore General Hospital, Singapore
Bee YC:
Singapore General Hospital, Singapore
Ya SR:
Singapore General Hospital, Singapore
Tee A:
Changi General Hospital, Singapore
Yan JJ:
Changi General Hospital, Singapore
Hong S:
Changi General Hospital, Singapore
Tan W:
Changi General Hospital, Singapore
Carter V:
Optimum Patient Care, Cambridge, UK
Hardaker L:
Optimum Patient Care, Cambridge, UK
McLaughlin A:
Optimum Patient Care, Cambridge, UK
Gouder C:
Mater Dei Hospital, Malta
Costello RW:
Royal College of Surgeons, Dublin, Ireland
Green Submitted
FULL TEXT
 |
Published Version |
|
| No Accesible |
|