Abu Hussein, Nebal S; Giezendanner, Stephanie; Urwyler, Pascal; Bridevaux, Pierre-Olivier; Chhajed, Prashant N; Geiser, Thomas; Joos Zellweger, Ladina; Kohler, Malcolm; Miedinger, David; Pasha, Zahra; Thurnheer, Robert; von Garnier, Christophe; Leuppi, Joerg D (2023). Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. Journal of clinical medicine, 12(20) MDPI 10.3390/jcm12206695
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BACKGROUND
Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP-based Swiss COPD cohort and develop a statistical model for predicting exacerbation.
METHODS
COPD cohort demographic and medical data were recorded for 24 months, by means of a questionnaire-based COPD cohort. The data were split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and its overall performance was validated. A nomogram was created to facilitate the clinical use of the model.
RESULTS
Of the 229 COPD patients analyzed, 77% of the patients did not experience exacerbation during the follow-up. The best subset in the training dataset revealed that lower forced expiratory volume, high scores on the MRC dyspnea scale, exacerbation history, and being on a combination therapy of LABA + ICS (long-acting beta-agonists + Inhaled Corticosteroids) or LAMA + LABA (Long-acting muscarinic receptor antagonists + long-acting beta-agonists) at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) value was 0.75 for one or more exacerbations. The calibration was accurate (0.34 predicted exacerbations vs 0.28 observed exacerbations).
CONCLUSION
Nomograms built from these models can assist clinicians in the decision-making process of COPD care.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology |
UniBE Contributor: |
Abu Hussein, Nebal, Geiser, Thomas (A) |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2077-0383 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Oct 2023 12:59 |
Last Modified: |
31 Oct 2023 14:29 |
Publisher DOI: |
10.3390/jcm12206695 |
PubMed ID: |
37892832 |
Uncontrolled Keywords: |
COPD exacerbation prediction primary health care recurrent exacerbations risk factors |
BORIS DOI: |
10.48350/188271 |
URI: |
https://boris.unibe.ch/id/eprint/188271 |
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