International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"A Systematic Literature Review of the Humanistic, Economic, Sociodemographic, and Environmental Burden Associated with Severe COPD.","authors":"Ioanna Vlachaki, Simon Donhauser, Robert A Wise, Yahong Chen, Alessandra Madoni, Ulrica Scaffidi Argentina, Jahangir Nabi Mir, Jennifer K Quint","doi":"10.2147/COPD.S510623","DOIUrl":"https://doi.org/10.2147/COPD.S510623","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a highly prevalent and progressive disease, hence greater understanding of its humanistic, economic, and environmental impact is essential for guiding effective management strategies. A systematic literature review (SLR; 2021-2023), complemented with a targeted literature review (TLR; 2013-2023) identified 2039 publications on the economic and humanistic burden of severe COPD. Additionally, an SLR and complementary TLR to evaluate the impact of environmental and sociodemographic factors on COPD (2013-2023), identified 1018 records. All searches were conducted on November 17, 2023. After applying prespecified selection criteria, 50 studies reporting on the humanistic and economic impact of COPD, and six studies on the environmental and sociodemographic impact, were selected. Severe COPD significantly impairs health-related quality of life, exerting effects on physical and psychological well-being, with a progressive decline as COPD worsens from mild to very severe. Evidence indicates that there is a significant burden of disease due to exacerbations of COPD, with their frequency and severity increasing with disease progression, and an increased mortality risk associated with very severe versus severe COPD. The studies reported a high frequency of healthcare resource utilization, including primary care visits, emergency department visits, and hospitalizations among patients with severe COPD, all of which contribute to a significant economic burden, particularly in patients with advanced disease. Environmental factors demonstrated diverse impacts on outcomes for individuals with severe COPD, varying by type of pollutant, disease severity, and patient characteristics. Studies examining the sociodemographic impact of underserved populations on the burden of severe COPD were not identified. Severe COPD is a multifaceted disease that imposes considerable humanistic and economic impact on both patients and healthcare systems. Further work is needed to understand the impact of environmental and sociodemographic factors on the burden of COPD, with such insights ultimately optimizing patient care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2493-2523"},"PeriodicalIF":2.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Lactic Dehydrogenase-to-Albumin Ratio and Short-Time Mortality in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Xiqing Yao, Haoyue Xue, Jiye Luo","doi":"10.2147/COPD.S521192","DOIUrl":"10.2147/COPD.S521192","url":null,"abstract":"<p><strong>Purpose: </strong>The lactate dehydrogenase-to-albumin ratio (LAR) has emerged as a prognostic marker for critically ill patients, yet its relationship with mortality in chronic obstructive pulmonary disease (COPD) remains poorly understood. Our purpose is to assess the predictive value of LAR in COPD patients.</p><p><strong>Patients and methods: </strong>In this retrospective cohort study, data were extracted from the MIMIC IV database. COPD patients were divided into two groups based on 28-day all-cause mortality. To investigate the relationship between LAR and short-term mortality, multivariate Cox regression, receiver operating characteristic (ROC) analysis, and Kaplan-Meier survival analysis were performed.</p><p><strong>Results: </strong>The study included 1048 COPD patients, with 37% experiencing 28-day mortality. LAR was identified as an independent predictor of 28-day mortality (hazard ratio [HR] 1.01, 95% confidence interval [CI]: 1.01-1.01, P < 0.001). ROC analysis showed that LAR had an area under the curve (AUC) of 69.48% (95% CI: 65.67-73.29%), demonstrating superior discriminatory power compared to lactate dehydrogenase (AUC = 66.69%) or albumin (AUC = 36.88%) alone. Additionally, LAR's predictive performance was comparable to that of the Simplified Acute Physiology Score II (SAPSII), which yielded an AUC of 76.8% (95% CI: 73.54-80.06%). COPD patients with high LAR values (>120) had significantly higher 28-day mortality rates (P < 0.001).</p><p><strong>Conclusion: </strong>Elevated LAR is an independent predictor of 28-day mortality in ICU patients with COPD. LAR proves to be a valuable prognostic tool that may assist in the early identification of high-risk patients with CPPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2435-2444"},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in COPD: Clinical Impact, Diagnosis, Biomarkers, and Management Strategies.","authors":"Rakhima Azhimamatova, Rana Sherbaevna Salieva, Tazagul Bayishbecovna Zalova, Kunduzkhan Karimova, Dilshat S Karimova, Shekerbubu Anarbekovna Dyikanova, Roman Kalmatov, Urmatbek M Tynaliev","doi":"10.2147/COPD.S522862","DOIUrl":"https://doi.org/10.2147/COPD.S522862","url":null,"abstract":"<p><p>Frailty is a complex clinical syndrome characterized by reduced physiological resilience and heightened susceptibility to external stressors, culminating in increased risks of functional decline, hospitalization, and mortality. In individuals with chronic obstructive pulmonary disease (COPD), frailty exacerbates disease burden and is closely linked to adverse outcomes, including increased exacerbation frequency, diminished quality of life, and poor prognosis. This review synthesizes current evidence on the interplay between frailty and COPD, emphasizing clinical implications, diagnostic frameworks, emerging biomarkers, and tailored management strategies. A systematic literature search was conducted across PubMed, Scopus, and Embase databases, employing key terms such as \"frailty\", \"chronic obstructive pulmonary disease\", \"COPD\", \"frailty assessment\", \"biomarkers\", and \"frailty management in COPD\". Inclusion criteria targeted English-language studies reporting original data with a direct focus on frailty in the context of COPD. By synthesizing multidimensional assessment strategies and potential therapeutic modalities, this review supports the development of precision-based interventions to reduce frailty and improve outcomes in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2445-2458"},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Density Lipoprotein Cholesterol as a Protective Factor in COPD and Implications for Statin Therapy: A Multi-Omics Genetic Epidemiology Study.","authors":"Tiantao Du, Jianye Cao, Ziyao Dai, Xianting Xie, Guoshu Zhang, Yulin Li, Baiyu Chen, Tao Xu, Jia Feng","doi":"10.2147/COPD.S516906","DOIUrl":"https://doi.org/10.2147/COPD.S516906","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a complex lung condition primarily affecting the airways and alveoli, characterized by persistent progressive airflow limitation. COPD ranks as the third leading cause of death worldwide, with its incidence and mortality rates escalating annually due to an aging population. This study aimed to explore the association between low-density lipoprotein cholesterol (LDL-C) and COPD, as well as the impact of statin drugs on the progression of COPD.</p><p><strong>Methods: </strong>Employing an integrated approach that encompasses observational studies, genetic epidemiology, and molecular biology, this research investigated the link between LDL-C and COPD using clinical survey data, genome-wide association study (GWAS) data, and transcriptomic data. Additionally, it assessed the potential role of statin drugs in the treatment of COPD.</p><p><strong>Results: </strong>The study discovered that LDL-C serves as a protective factor for COPD, and statin drugs may promote the progression of COPD by reducing LDL-C levels. This finding provides a new perspective on the metabolic disruptions in COPD and offers significant guidance for future therapeutic strategies.</p><p><strong>Conclusion: </strong>This research confirms the inverse correlation between LDL-C and COPD and reveals that statin drugs might influence the progression of COPD by affecting LDL-C levels. These findings underscore the importance of considering metabolic factors in COPD management and suggest new directions for therapeutic strategies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2409-2422"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dietary Inflammatory Index (DII) and COPD: A Cross-Sectional Study from the NHANES.","authors":"Zhi Jian Luo, Haiying Yang, Yuan Wang","doi":"10.2147/COPD.S523653","DOIUrl":"https://doi.org/10.2147/COPD.S523653","url":null,"abstract":"<p><strong>Background: </strong>While diet may impact the risk of chronic obstructive pulmonary disease (COPD), the relationship between COPD and dietary inflammatory potential remains largely unexplored. This study aimed to evaluate the association between COPD status and the dietary inflammatory index (DII).</p><p><strong>Methods: </strong>Utilizing NHANES data from 2013 to 2018, the study investigated the relationship between Dietary Inflammatory Index (DII) scores, derived from 24-hour dietary recall interviews, and COPD status. Weighted logistic regression and restricted cubic spline (RCS) analyses were employed to assess this association. Additionally, stratified and interaction analyses were conducted to evaluate the consistency of the relationship and identify potential modifiers.</p><p><strong>Results: </strong>Individuals diagnosed with COPD demonstrated significantly elevated DII scores in comparison to those without COPD. An increment of one unit in the DII was correlated with an increased risk of developing COPD, as indicated by an odds ratio (OR) of 1.05 (95% CI:1.09, 1.21; <i>P</i>=0.007). Following comprehensive multivariate adjustments, the odds ratio for COPD, when comparing individuals in the highest quartile of DII scores to those in the lowest quartile, was 1.34 (95% CI:1.01, 1.77; <i>P</i><0.001). A positive linear association was observed between DII and COPD, although the relationship was nonlinear (<i>P</i>=0.618). Moreover, the association between DII and COPD was consistent across various stratified analyses.</p><p><strong>Conclusion: </strong>The study results imply that consuming a pro-inflammatory diet is connected to a greater chance of developing COPD among US residents. Dietary strategies aimed at reducing inflammation might help in preventing COPD and associated illnesses.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2423-2434"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Quality of Life of Patients with COPD with Different Degrees of Exercise-Induced Desaturation on Six-minute Walk Test.","authors":"Beiyao Gao, Siyuan Wang, Li Zhao, Hongbin Liao, Shiwei Qumu, Peijian Wang, Ting Yang, Shan Jiang","doi":"10.2147/COPD.S513089","DOIUrl":"https://doi.org/10.2147/COPD.S513089","url":null,"abstract":"<p><strong>Objective: </strong>To identify predictive factors for different exercise-induced desaturation (EID) severities and evaluate health-related quality of life six months later in chronic obstructive pulmonary disease (COPD) patients.</p><p><strong>Methods: </strong>This retrospective study consecutively analyzed 116 COPD outpatients (male: 82.8% [96/116]; age: 63.48 ± 7.48 years; disease severity distribution: GOLD 1/2/3/4 = 55.8%/34.6%/7.7%/1.9%). Patients were categorized into three groups based on oxygen desaturation (SpO₂) during the six-minute walk test (6MWT): non-EID (n = 52), mild-EID (n = 42), and severe-EID (n = 22). EID was classified as follows: Mild EID: SpO₂ decrease ≥4% with nadir SpO₂ ≥90%. Severe EID: SpO₂ decrease ≥4% with nadir SpO₂ ≤90%. Non EID: SpO₂ decrease <4% with nadir SpO₂ ≥90%. A six-month follow-up was conducted via telephone to record adverse events and assess quality of life using the Chinese version of the EQ-5D questionnaire, which includes five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, along with the EQ-VAS scale.</p><p><strong>Results: </strong>Significant differences were observed across the three groups in peripheral blood oxygen saturation (SpO₂, %), peak expiratory flow (PEF, L/s), PEF (%), forced expiratory volume in the first second (FEV1, L), FEV1 (%), 6MWT distance (6MWD, m), Borg dyspnea, and Borg fatigue scores. The optimal cutoff values for predicting EID severity was 54.45% for FEV1% (AUC=0.716), 450.5 m for 6MWD (AUC = 0.761), and 94.5% for resting SpO₂ (AUC = 0.737). Multivariate logistic regression analysis identified low FEV1%, reduced 6MWD, and low resting SpO₂ as risk factors for severe EID (FEV1%: p = 0.002; 6MWD: p = 0.008; SpO₂: p = 0.018. Severe EID patients had significantly lower EQ-5D index and EQ-VAS scores (EQ-5D index: p = 0.002; EQ-VAS: P = 0.005), particularly in mobility and usual activities dimensions (mobility: p = 0.001; usual activities: p = 0.038).</p><p><strong>Conclusion: </strong>Low FEV1%, reduced 6MWD, and low resting SpO₂ are key risk factors for severe EID, provide practical thresholds for clinical management of EID in COPD patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2381-2391"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture for Chronic Obstructive Pulmonary Disease: A 38-Year Bibliometric Landscape of Global Research Trends and Knowledge Evolution (1986-2024).","authors":"Kaiting Wu, Chen Ruan","doi":"10.2147/COPD.S531611","DOIUrl":"10.2147/COPD.S531611","url":null,"abstract":"<p><strong>Background: </strong>Despite growing interest in acupuncture as a complementary therapy for chronic obstructive pulmonary disease (COPD), comprehensive analyses of its global research trajectory, disciplinary convergence patterns, and geopolitical contributions remain unexplored. This study addresses this gap by mapping the intellectual and geopolitical architecture of acupuncture-COPD research over nearly four decades, a period chosen to capture the significant developments in acupuncture's global recognition since the late 1980s, when traditional medicine began to gain more global attention.</p><p><strong>Methods: </strong>We conducted a longitudinal bibliometric analysis of 299 publications indexed in the Web of Science Core Collection (1986-2024). Employing Bradford's and Lotka's laws, co-citation networks, and keyword co-occurrence clustering, we systematically evaluated temporal productivity trends, institutional/country contributions, citation dynamics, and thematic evolution using SciMAT, VOSviewer, and bibliometrix R-package. (Response to Editor's Comment 1).</p><p><strong>Results: </strong>Research productivity followed a triphasic trajectory: a dormant phase (1986-2000, ≤2 articles/year), a stabilization phase (2001-2014, +4% annual growth), and an exponential growth phase (2015-2024, 13 articles/year), closely aligned with global policy shifts in traditional medicine. China emerged as the dominant contributor (338 articles, 64.2% global output), yet Canada demonstrated superior research impact (108 citations/article), highlighting a productivity-impact paradox. Mechanistic investigations into neuroimmunological pathways, particularly μ-opioid receptor modulation (centrality 0.74), became central research pillars, reinforced by biomarker-correlated clinical trials showing β-endorphin-FEV1 interactions (r = 0.526, p = 0.008). Persistent translational gaps were evident, with 63% of RCTs relying on subjective \"deqi\" assessments despite technological advances in objective acupuncture monitoring.</p><p><strong>Conclusion: </strong>This analysis reveals critical asymmetries between Eastern research productivity and Western methodological innovation in acupuncture-COPD research. This analysis suggests a need for a threefold strategy integrating multiscale neuroimaging validation, globalized trial standardization through CONSORT-Acupuncture frameworks, and equitable North-South knowledge exchange to address the growing burden of COPD-related dyspnea in aging populations.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2393-2408"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Laser System-Assisted CT-Guided Percutaneous Transthoracic Lung Biopsy in Patients with COPD Combined with Pulmonary Nodules.","authors":"Chao Li, Xiao Hu, Cheng Li, Gang Jiang, Yong Liang Jiang","doi":"10.2147/COPD.S530756","DOIUrl":"10.2147/COPD.S530756","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis and management of pulmonary nodules in patients with COPD are challenging, as these nodules may represent either lung cancer or other pulmonary diseases. This study aims to evaluate the efficiency of a novel laser systems (LGS)-assisted CT-guided percutaneous lung biopsy in COPD patients with pulmonary nodules.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the data of 60 COPD patients with pulmonary nodules. Thirty patients (n=30) underwent CT-guided percutaneous transthoracic lung biopsy assisted by LGS, while the remaining 30 (n=30) underwent conventional manual CT-guided percutaneous transthoracic lung biopsy. The surgical time, number of punctures, CT scan frequency, and complications were compared between the two groups.</p><p><strong>Results: </strong>No significant differences were found between the two groups in terms of clinical characteristics, lesion size, location, puncture depth, or nodule nature. Compared to the traditional method, LGS-assisted CT-guided percutaneous lung biopsy significantly reduced the number of CT scans (2.3 ± 0.5 vs 3.2 ± 0.6, P < 0.001) and the average procedure time (12.6 ± 2.7 min vs 25.1 ± 3.4 min, P < 0.001). Additionally, the total intraoperative time per procedure was significantly reduced (25.1 ± 3.4 min vs 45.9 ± 8.8 min, P < 0.001). With the use of LGS, 73% (22/30) of the procedures hit the target on the first needle insertion, compared to only 6.7% (2/30) in the conventional group. Furthermore, there was no significant difference in the incidence of complications between the two groups.</p><p><strong>Conclusion: </strong>Compared to the traditional method, the use of LGS improved puncture efficiency in COPD patients, reduced the need for needle adjustments, and effectively shortened the procedure time.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2371-2379"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Telemonitoring on Moderate and Severe Exacerbations in Patients with COPD: Pooled Analysis of Two Randomized Controlled Trials in Denmark.","authors":"Charlotte Hyldgaard, Thomas Ringbæk, Frank Dyekjær Andersen, Ejvind Frausing Hansen, Michael Skov Jensen, Morten Fenger-Grøn, Christian Trolle, Charlotte Suppli Ulrik","doi":"10.2147/COPD.S528852","DOIUrl":"10.2147/COPD.S528852","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious events with high morbidity and mortality. Previous studies investigated telemonitoring as a tool for prevention of hospitalizations with ambiguous results. The aim of the present study was to combine data from two randomized controlled trials conducted in Denmark in similar healthcare settings to explore number of hospitalizations for COPD, days of admission, and exacerbations treated outside hospitals.</p><p><strong>Methods: </strong>Recruitment took place during hospitalization for AECOPD and from outpatient COPD clinics. Patients were equally randomized to telemonitoring (N=251) in addition to usual care for six months or usual care alone (N=252). We used a negative binomial regression model with between-group comparisons expressed as incidence rate ratios (IRRs) for assessment of hospitalizations, admission days and moderate exacerbations and Kaplan-Meier time-to-event analysis for assessment of time to first COPD hospitalization.</p><p><strong>Results: </strong>No significant differences between the two studies were identified. In combined analyses, numerically fewer hospitalizations (IRR 0.85, 95% CI 0.62-1.17) and hospitalization days (IRR 0.72, 95% CI 0.42-1.23) were seen in the telemonitoring group, but the findings did not reach statistical significance whereas treatment for moderate exacerbations was significantly more frequent in the telemonitoring group (IRR 1.91, 95% CI 1.49-2.45).</p><p><strong>Conclusion: </strong>No effect of telemonitoring on hospitalizations for AECOPD was documented in this large cohort of patients with severe COPD. However, the telemonitoring group received significantly more treatment for moderate exacerbations. This risk of overtreatment should be considered when telemonitoring is used in the care of patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2361-2369"},"PeriodicalIF":2.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Initial Treatment Failure in Inpatients with Exacerbation of Chronic Obstructive Pulmonary Disease: A Cohort Study.","authors":"Noriko Kohyama, Kuniaki Hirai, Hironori Sagara, Miki Takenaka Sato, Masayuki Ohbayashi, Mari Kogo","doi":"10.2147/COPD.S516855","DOIUrl":"10.2147/COPD.S516855","url":null,"abstract":"<p><strong>Purpose: </strong>Some patients do not respond to initial therapy for exacerbation of chronic obstructive pulmonary disease (ECOPD), resulting in treatment failure that requires antimicrobial changes or advanced therapies. Appropriate treatment is possible if patients at a high risk of treatment failure at the start of treatment are properly identified. Therefore, this study examined the factors associated with initial treatment failure in patients with ECOPD.</p><p><strong>Patients and methods: </strong>We conducted a cohort study involving patients with ECOPD admitted to our hospital. The primary outcome was initial treatment failure, defined as a composite of treatment intensification for ECOPD and in-hospital mortality. Uni- and multivariate analyses were performed to identify the factors associated with initial treatment failure.</p><p><strong>Results: </strong>The analysis included data of 152 patients with a mean age of 76±8 years (mean±standard deviation); 81% of them were male patients. Treatment failure occurred in 26 (17%) patients. These included nine, two, one, and 14 patients who changed antimicrobial agents, received additional non-invasive positive pressure ventilation therapy due to non-improvement or symptom exacerbation, received additional invasive positive pressure ventilation therapy, and died in the hospital, respectively. Using multivariable analysis, home oxygen therapy (odds ratio, 5.335; 95% confidence interval, [1.542-18.457]), neutrophil count ≥7000 cells/µL (3.550; [1.007-12.519]), and acidemia (3.129; [1.009-9.698]) were significant factors associated with treatment failure. In patients treated with narrow-spectrum antibiotics as the initial antibacterial therapy, the treatment failure rate in patients receiving home oxygen therapy was significantly higher than in those receiving none.</p><p><strong>Conclusion: </strong>Home oxygen therapy, high neutrophil count, and acidemia on admission were risk factors for treatment failure. Particularly, patients receiving home oxygen therapy were at a higher risk of treatment failure with the use of narrow-spectrum antibiotics.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2349-2360"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}