Risk factors for Progression to Frequent Exacerbators in Stable Patients with COPD.

Abstract

Background: Little is known about the transition to frequent exacerbators in stabilized patients with chronic obstructive pulmonary disease (COPD).

Methods: This study utilized data obtained from the Korean COPD subgroup study cohort (KOCOSS), including 511 patients with infrequent exacerbations. The outcome for these groups was progression to frequent exacerbators. Multivariable logistic regression analysis was used to investigate the risk factors for progression.

Results: Within one year, 40 patients (7.8%) progressed to frequent exacerbators. Among those patients with severe airflow limitation and those who used inhaled corticosteroids (ICS), incidence of progression was significantly higher. The risk factors for this progression were older age (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.19-3.34; per 10-year increase), decreased post-bronchodilator forced expiratory volume in 1 second (aOR = 1.32, 95% CI = 1.05-1.66; per 10% predicted decrease), increased blood eosinophil count (aOR = 1.21, 95% CI = 1.08-1.35; per 100 cells/μL increase), and use of ICS/long-acting beta-agonists (LABA) (aOR = 9.16, 95% CI = 1.38-60.82) and ICS/LABA/long-acting muscarinic antagonists (aOR = 8.00, 95% CI = 1.25-51.18).

Conclusions: Among stable COPD patients, older age, decreased lung function, increased eosinophil counts, and use of ICS-containing inhalers were associated with progression to frequent exacerbators.