COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Management of COPD-OSA Overlap Syndrome Beyond Standard Care.","authors":"Athanasios Voulgaris, Athena Gogali, Konstantinos Kostikas, Paschalis Steiropoulos","doi":"10.1080/15412555.2025.2599583","DOIUrl":"10.1080/15412555.2025.2599583","url":null,"abstract":"<p><p>The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA), known as overlap syndrome (OS), presents unique diagnostic and therapeutic challenges. Patients with overlap syndrome exhibit more severe hypoxemia, higher cardiovascular risk, and increased COPD exacerbations compared to those with either condition alone. While treatment with positive airway pressure (PAP) remains the cornerstone of OSA management, its role in patients with OS requires more sophisticated application, particularly in the presence of hypercapnia or poor PAP tolerance. The present review synthesizes current evidence on the pathophysiology, clinical presentation, and management of patients with overlap syndrome, emphasizing the limitations of standard care. Moreover, the utility of noninvasive ventilation, pharmacologic strategies beyond PAP, and tailored screening tools are explored. Finally, it highlights the need for a comprehensive, individualized approach to the management of patients with overlap syndrome and calls for further research to refine treatment algorithms and improve patient outcomes.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2599583"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Lung Volume Reduction Therapies in Patients with Emphysema: A Systematic Review and Network Meta-Analysis\".","authors":"Arun Kumar, Ankur Sharma, Saumya Das, Preeti Dnyandeo Sonje, Dhanya Dedeepya","doi":"10.1080/15412555.2025.2600400","DOIUrl":"https://doi.org/10.1080/15412555.2025.2600400","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2600400"},"PeriodicalIF":2.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin 1-Beta Potentially Contributes to Chronic Obstructive Pulmonary Disease Development by Inducing Reactive Oxygen Species Production in Neutrophils.","authors":"Jingjing Mei, Yuanhua Liu, Yan Kang, Ruyi Li, Jianjun Jin","doi":"10.1080/15412555.2026.2650126","DOIUrl":"10.1080/15412555.2026.2650126","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is characterized by persistent airway inflammation and excessive mucin production. Two major gel-forming mucins, MUC5AC and MUC5B, correlate with worsened disease progression and pulmonary function. In COPD, neutrophils are important players in chronic inflammation that contribute to tissue damage through releasing reactive oxygen species (ROS). IL-1β, a pro-inflammatory cytokine, plays various roles in COPD disease progression. It is known to recruit and activate neutrophils and is also known to induce mucin production in bronchial epithelium. This study aimed to investigate whether IL-1β induces ROS production in neutrophils and whether neutrophil-derived ROS drives mucin secretion in bronchial epithelial cells. HL-60-derived neutrophils were treated with IL-1β or vehicle and neutrophil ROS production was assessed through flow cytometry. Using a co-culture system, human bronchial epithelial cells were exposed to IL-1β-treated neutrophils, and MUC5AC and MUC5B levels on these cells were evaluated at RNA and protein levels through RT-qPCR, immunofluorescence, and ELISAs. IL-1β induced neutrophil ROS production. The elevated ROS production in neutrophils induced MUC5AC and MUC5B production at mRNA and protein levels in bronchial epithelial cells. Inhibition of ROS production in neutrophils using a NOX2 inhibitor reduced MUC5AC and MUC5B secretion in bronchial epithelial cells. IL-1β-induced neutrophil-derived ROS is a key driver of mucin hypersecretion in bronchial epithelial cells, potentially contributing to COPD disease progression.</p><p><p><b>Trial registration:</b> Not applicable.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2650126"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Post-Discharge Predictors of Sedentary Behavior Following COPD Exacerbation: An Observational Study. Authors' Responses.","authors":"Maria Gabriela Colucci, Joana Cruz, Luiz Augusto Brusaca, Débora Mayumi de Oliveira Kawakami, Gustavo Henrique Guimarães Araujo, Manuela Karloh, Renata Gonçalves Mendes, Valéria Amorim Pires Di Lorenzo","doi":"10.1080/15412555.2026.2641663","DOIUrl":"https://doi.org/10.1080/15412555.2026.2641663","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2641663"},"PeriodicalIF":2.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Post-Discharge Predictors of Sedentary Behavior Following COPD Exacerbation: An Observational Study.","authors":"Maria Gabriela Colucci, Joana Patrícia Dos Santos Cruz, Luiz Augusto Brusaca, Débora Mayumi de Oliveira Kawakami, Gustavo Henrique Guimarães Araujo, Manuela Karloh, Renata Gonçalves Mendes, Valéria Amorim Pires Di Lorenzo","doi":"10.1080/15412555.2025.2600130","DOIUrl":"10.1080/15412555.2025.2600130","url":null,"abstract":"<p><p>Patients hospitalized due to an exacerbation of chronic obstructive pulmonary disease (ECOPD) often exhibit increased sedentary behavior (SB), which may persist after discharge and negatively affect recovery. However, early determinants of SB during this period remain unclear. To identify the factors at hospital discharge that predict SB 30 days later in patients with ECOPD. This observational longitudinal study included patients hospitalized for ECOPD, assessed during the first week after discharge and reassessed 30 days later. Data collected included sociodemographic information (age, sex, name, telephone number, and address), anthropometric measurements (weight, height, and body mass index [BMI]), clinical history (previous hospitalizations, exacerbations, and smoking status), dyspnea (Medical Research Council scale, mMRC), health status (COPD Assessment Test, CAT), co-morbidities (Charlson Comorbidity Index), and exercise capacity (6-minute walk test, 6MWT). Physical activity and sedentary behavior-including SB, light (LPA), moderate (MPA), and vigorous (VPA) physical activity, step count, and sleep-were measured using a triaxial accelerometer worn for seven consecutive days. Accelerometer data were processed with ActiPASS software, and statistical analyses were performed in RStudio. Stepwise regression analysis was used to identify the discharge variables that could predict SB at 30 days. Forty-four patients (61% female; age 66 ± 8 years; FEV₁ 53 ± 13%; Charlson 1 [1-2]; hospital stay 5 [3-6] days) were included. At discharge, median mMRC was 3 (2-3), CAT 21 ± 8, 6MWT 274 ± 102 m, steps/day 3,148, SB 619 ± 226 min/day, and LPA 216 min/day. At 30 days, SB was 615 ± 166 min/day. Dyspnea (mMRC) and LPA at discharge explained SB at 30 days (R² = 0.31, <i>p</i> < 0.001). Higher levels of dyspnea and lower levels of LPA during the first week after discharge are the significant predictors of SB 30 days after hospitalization for ECOPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2600130"},"PeriodicalIF":2.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>LncTUG1</i> Regulates miR-181a/<i>BPIFB4</i> Axis to Promote COPD Inflammation.","authors":"Awaguli Tuersun, Jingran Xu, Zulipikaer Abudureheman, Ayiguli Alimu, Aifang Zheng, Tao Ma, Yaping Zhou, Xiuqi Lu, Lexin Xue, Yun Chen, Li Li","doi":"10.1080/15412555.2026.2649605","DOIUrl":"10.1080/15412555.2026.2649605","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is associated with high mortality and morbidity, with a complex inflammatory mechanism. Previous studies have demonstrated that Bactericidal/Perme Ability-Increasing Fold-Containing Family B member 4 (<i>BPIFB4)</i> plays a significant role in maintaining inflammatory balance. This study aimed to explore the roles of <i>BPIFB4</i>, microRNA (miR)-181a, and long non-coding (lnc) RNA <i>TUG1</i> in COPD inflammatory processes.</p><p><strong>Methods: </strong>Induced sputum was collected from 20 COPD patients and 20 healthy controls. THP-1 cells were treated with cigarette smoke extract (CSE) to simulate an <i>in vitro</i> inflammatory response. Expression levels of <i>BPIFB4</i>, <i>LncTUG1</i>, and miR-181a were detected by qPCR and western blot. Bioinformatic prediction and dual luciferase assays were used to predict the targeting relationship. Flow cytometry and ELISA assays evaluated the content of macrophages and inflammatory cytokines, respectively.</p><p><strong>Results: </strong>The expression levels of <i>BPIFB4</i> and <i>LncTUG1</i> were elevated in COPD patients, while miR-181a expression was downregulated. <i>BPIFB4</i> and <i>LncTUG1</i> were direct targets of miR-181a. Overexpression of <i>BPIFB4</i> led to increased M2 macrophages and related anti-inflammatory cytokines. In contrast, silencing <i>BPIFB4</i> resulted in elevated M1 macrophages and associated cytokines. Silencing <i>LncTUG1</i> elevated miR-181a expression, reduced <i>BPIFB4</i> expression, and increased M1-type macrophages and pro-inflammatory factors, while overexpression of <i>LncTUG</i>1 showed the opposite effects.</p><p><strong>Conclusions: </strong>This study concludes that downregulation of <i>LncTUG1</i> promotes inflammation by reducing <i>BPIFB4</i> expression through miR-181a. Overexpression of <i>BPIFB4</i> promotes macrophage polarization toward the M2 type, thereby alleviating the inflammatory response in COPD. These findings provide theoretical support and potential new targets for COPD treatment.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2649605"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Adherence to Non-Invasive Ventilation on Prognosis in Patients With Overlap Syndrome.","authors":"Wen-Jing Liu, Fang Ding, Hong Guo, Jie-Mei Li, Wei Guo, Jing Wang, Zhao-Bo Cui","doi":"10.1080/15412555.2026.2711351","DOIUrl":"10.1080/15412555.2026.2711351","url":null,"abstract":"<p><p>This study aimed to investigate the impact of adherence to non-invasive ventilation (NIV) on the prognosis of patients with overlap syndrome (OS). This retrospective cohort study included 115 hospitalised patients with OS who initiated home NIV therapy and were followed up for 12 months. Adherence was classified as good (≥4 h/d) or poor (<4 h/d). Outcomes included annual exacerbation frequency, time to first exacerbation, severity of exacerbations, and St. George's Respiratory Questionnaire (SGRQ) scores. Initiating NIV treatment during hospitalisation was associated with a higher rate of NIV acceptance at home (33.99% vs. 11.34%, <i>p</i> < 0.001); however, there was no control group for treatment initiated on an outpatient basis. Good adherence significantly delayed the first acute exacerbation (log-rank test = 13.032, <i>p</i> < 0.001) and reduced the annual exacerbation rate (0.89 ± 0.86 vs. 1.24 ± 0.98, <i>p</i> = 0.041), but did not affect the severity of exacerbations. SGRQ scores at 6 and 12 months were better in the good adherence group (<i>p</i> < 0.05). There were no differences between groups in eosinophil counts or the use of benzodiazepines and opioids. This study demonstrates that good adherence to home NIV therapy following AECOPD significantly delays time to first exacerbation and reduces annual exacerbation frequency in patients with OS, while improving health-related quality of life. Additionally, in-hospital NIV initiation was associated with higher rates of home NIV acceptance compared to outpatient initiation, though this secondary finding requires prospective validation with appropriate comparator groups. These findings support the implementation of systematic screening and early intervention strategies for OS patients hospitalised for AECOPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2711351"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic Lung Volume Reduction in Patients on Chronic Anticoagulation: Insight from the National Inpatient Sample Database.","authors":"Muhammad Sarmad Aleem, Adishwar Rao, Shital Oli, Asmita Paudel, Maheen Anwar, Hammad Munir Malik, Shubhendu Bajpai, Faraz Siddiqui, Boyd Hehn","doi":"10.1080/15412555.2026.2741053","DOIUrl":"https://doi.org/10.1080/15412555.2026.2741053","url":null,"abstract":"<p><p>Bronchoscopic lung volume reduction (BLVR) is a minimally invasive option for advanced COPD, but carries bleeding risk. A significant proportion of COPD patients requiring BLVR are on chronic anticoagulation, yet data on procedural safety in this population remains scarce. We conducted a retrospective study using the National Inpatient Sample (NIS) database (2016-2023). Adult BLVR patients were stratified by chronic anticoagulation status. The primary outcomes were hemothorax and pulmonary bleeding. Secondary outcomes included any bleeding (gastrointestinal, pulmonary, intracranial, retroperitoneal, hematuria, hemothorax, or acute blood loss anemia), pneumothorax, in-hospital mortality, major adverse cardiac events (MACE), and prolonged hospitalization (≥7 days). Multivariable logistic regression yielded adjusted odds ratios (aORs) controlling demographics, comorbidities, and hospital characteristics. Of 16,340 weighted BLVR hospitalizations, 1,275 (7.8%) involved anticoagulated patients. Anticoagulated patients were older (68.6 vs. 65.7 years) and more frequently male (70.6% vs. 58.5%), with a higher burden of cardiovascular comorbidities. Hemothorax and pulmonary bleeding occurred in 2.7% and 7.1% of anticoagulated patients versus 1.1% and 4.7% of non-anticoagulated patients, respectively. Any bleeding occurred in 14.1% of anticoagulated versus 10.8% of non-anticoagulated patients. These differences were not statistically significant, and chronic anticoagulation was not independently associated with any increased bleeding on multivariable analysis. No significant differences were observed in mortality (aOR 0.88), pneumothorax (aOR 0.72), MACE (aOR 1.13), or prolonged hospitalization (aOR 1.09). Chronic anticoagulation was not independently associated with adverse outcomes following BLVR, suggesting comparable short-term outcomes in this population. Prospective studies examining the timing and types of anticoagulation in BLVR are warranted.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2741053"},"PeriodicalIF":2.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Patients with Long-Term Oxygen Therapy: A Nationwide Belgian Cohort Study.","authors":"Michaël Staes, Arne Coussement, Geert Celis, Stephanie Everaerts, Eric Derom, Wim Janssens","doi":"10.1080/15412555.2026.2720037","DOIUrl":"https://doi.org/10.1080/15412555.2026.2720037","url":null,"abstract":"<p><p>Long-term oxygen therapy (LTOT) for patients with severe chronic hypoxemia is a well-established treatment, but data on long-term outcomes are limited. This study aims to describe the characteristics and survival of patients using LTOT in Belgium. Data from patients receiving LTOT were extracted from the Belgian Social Security databank with 4 years of follow-up and compared with a more detailed tertiary care cohort from the University Hospital of Leuven. Kaplan-Meier curves for overall and transplant-free survival were constructed. We performed log-rank univariate analyses for diagnosis and starting treatment modality and applied a Cox proportional hazards model adjusting for age and underlying diagnosis. In Belgium, 4973 patients started LTOT in 2017. Overall 4-year survival was 22% and determined by age, baseline oxygen modality and diagnosis. LTOT was primarily prescribed for patients with COPD (75%) who had higher 4-year survival (24%) compared to patients with restrictive pulmonary disease (17%) (HR 1.23, <i>p</i> < 0.005). In the University hospital cohort (<i>n</i> = 533), 4-year transplant-free survival was 26% with significantly lower survival rates of patients with ILD (13%) (HR 1.98, <i>p</i> < 0.005) and other obstructive lung diseases (24%) (HR 1.56, <i>p</i> < 0.01) as compared to COPD (33%). Survival for patients receiving LTOT remains poor. Best prognosis is seen in patients with COPD, while patients with restrictive pulmonary disease and ILD in particular have the poorest outcome. Palliative care and end-of-life discussions should be an integral part of prescribing LTOT.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2720037"},"PeriodicalIF":2.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal Patterns and Short-Term Environmental Associations with AECOPD Hospitalizations in Shijiazhuang, China, 2020-2024.","authors":"Siqin Han, Zaixing Jia, Jialun Chen, Jing Cao, Jingwen Li, Xixin Yan","doi":"10.1080/15412555.2026.2723102","DOIUrl":"https://doi.org/10.1080/15412555.2026.2723102","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the seasonal distribution of AECOPD hospitalizations in Shijiazhuang (2020-2024), the lag associations of air pollutants (PM2.5, PM10, NO&lt;sub&gt;2&lt;/sub&gt;, O&lt;sub&gt;3&lt;/sub&gt;, SO&lt;sub&gt;2&lt;/sub&gt;, CO) and meteorological factors (mean temperature, diurnal temperature range) across seasons, and to explore the season-specific models for high-incidence admission days as an exploratory environmental-surveillance analysis rather than a ready-to-deploy clinical early-warning system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This city-wide retrospective time-series study analyzed 22,468 AECOPD admissions in Shijiazhuang from January 1, 2020 to December 31, 2024, using hospitalization front-page records covering all tertiary, secondary, and community hospitals in the city, obtained from the municipal medical insurance database (inpatient admissions only; ED discharges without admission were not included). Each year was divided by solar terms into spring (3/7-6/7), summer (6/8-9/7), autumn (9/8-12/7), and winter (12/8-3/6), with daily air pollution and meteorological data matched to admissions. Univariate and multivariate Poisson generalized linear regression (GLM) assessed single-day lag associations (lags 0-7 as eight separate lags); multivariable models and prediction features used the 7-day mean of lags 0-6 (admission day + preceding 6 days), not an 8-day lag0-7 average. Using each factor's 7-day cumulative window as input, we built logistic regression, random forest, and gradient boosting models and evaluated high-incidence-day prediction &lt;i&gt;via&lt;/i&gt; fivefold time-series cross-validation, treating the many lag × pollutant × season tests as exploratory. Sensitivity analyses added during revision included collinearity diagnostics (VIF/correlation matrix), quasi-Poisson models with smooth time, a distributed-lag nonlinear temperature model (DLNM), COVID-period analyses, humidity/heating checks, alternative lag windows, and a near-term exposure prediction re-run.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AECOPD admissions peaked in winter and were the lowest in summer (winter 6,009; spring 5,854; autumn 5,554; summer 5,051); the male-to-female ratio was ∼3.7:1 and mean age 71.7 ± 9.1 years. After multivariate adjustment, each 10 µg/m³ rise in winter PM10 and NO&lt;sub&gt;2&lt;/sub&gt; was associated with a 6.9% (IRR 1.069, 95%CI 1.052-1.085) and 8.9% (1.089, 1.050-1.129) higher admission rate, respectively. A 1 °C fall in mean temperature corresponded to a 4.4% increase (IRR 0.958, 0.947-0.969) and a 1 °C wider diurnal range to a 5.5% increase (1.055, 1.034-1.077). O&lt;sub&gt;3&lt;/sub&gt; was positively associated in summer and autumn (1.035, 1.015-1.056; 1.022, 1.005-1.039). Apparent protective multipollutant IRRs (e.g., winter PM2.5) were interpreted cautiously given collinearity. Prediction discrimination was the modest even when above chance: winter random forest fivefold CV AUC of 0.653 ± 0.112; other seasons ranged 0.50-0.62. Overall, environmental exposures were w","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2723102"},"PeriodicalIF":2.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}