International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD.","authors":"Qinglin Chen, Xinmao Wang, Xiujuan Yao, Luo Zhang, Xiaofang Liu","doi":"10.2147/COPD.S518218","DOIUrl":"10.2147/COPD.S518218","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to explore the predictive value of the chronic obstructive pulmonary disease (COPD) specific comorbidity test index (COTE) and pulmonary comorbidities for moderate-to-severe acute exacerbation and hospitalization in COPD patients.</p><p><strong>Patients and methods: </strong>This was a retrospective cohort study. We included 470 patients with stable COPD. Patients were divided into high or low-risk comorbidity group according to whether COTE score ≥4, and pulmonary comorbidities and extrapulmonary comorbidities group according to comorbidity origin. Moderate-to-severe acute exacerbation events and other clinical parameters were compared between groups. Multifactorial analysis and Lasso regression were used to screen risk factors and establish predictive models for moderate-to-severe acute exacerbation and hospitalization. The receiver operating characteristic (ROC) curve was used to assess the value COTE score and pulmonary comorbidities in predicting moderate-to-severe acute exacerbation and hospitalization.</p><p><strong>Results: </strong>When compared with the low-risk comorbidity and extrapulmonary comorbidities group, the rate of patients with ≥2 moderate-to-severe acute exacerbations and requiring hospitalization due to acute exacerbations is higher in high-risk comorbidity and pulmonary comorbidities group (χ²=18.45, χ²=40.15, χ²=8.82, χ²=23.68). Multifactorial analysis showed that comorbid with asthma, lung cancer were risk factors for moderate-to-severe acute exacerbations, while asthma, bronchiectasis, lung cancer, and high COTE score were risk factors for patients requiring hospitalization due to acute exacerbations. The AUC for COTE > 5.5 and a combination of at least one pulmonary comorbidity as potential indication of moderate-to-severe acute exacerbations of COPD and hospitalization due to acute exacerbations was 0.667 (95% CI: 0.615, 0.719) and 0.740 (95% CI: 0.688, 0.792), respectively. The prediction models including COTE and pulmonary comorbidities can predict moderate-to-severe acute exacerbations (internal validation of AUC: 0.984, 95CI%: 0.964-1) and hospitalization (internal validation of AUC: 0.978, 95CI%: 0.959-0.998) of COPD.</p><p><strong>Conclusion: </strong>COTE score and a combination of at least one pulmonary disease can predict the risk of moderate-to-severe acute exacerbations and hospitalization due to acute exacerbations in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1893-1913"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310639","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 Outcomes of People With COPD Who Experience Exacerbations While on Inhaled Triple Therapy: Results of the SIRIUS I Cohort Study in the US (2015-2019).","authors":"Clementine Nordon, Donna Carstens, Malin Fagerås, Hana Müllerová, Phani S Veeranki, João André Alves, Hayley D Germack, Timothy L Barnes, Meredith C McCormack","doi":"10.2147/COPD.S513573","DOIUrl":"10.2147/COPD.S513573","url":null,"abstract":"<p><strong>Purpose: </strong>Many people with chronic obstructive pulmonary disease (COPD) continue to experience frequent moderate/severe exacerbations despite treatment with inhaled triple therapy (TT). We evaluated the baseline characteristics and outcomes (exacerbation rate, mortality, and healthcare resource utilization [HCRU]) of this COPD population, overall and by smoking status.</p><p><strong>Patients and methods: </strong>A retrospective real-world cohort study of US patients was conducted using Optum's deidentified Market Clarity Data, an integrated claims and electronic health record database (study period: 2015-2019). Patients eligible for inclusion were aged ≥40 years, with a COPD diagnosis, continuous 12-month (baseline) period of treatment with TT, and record of ≥2 moderate or ≥1 severe exacerbation during baseline. Follow-up was either variable (from end of baseline to death, loss to follow-up, or end of 2019) or fixed (12 months). Baseline characteristics and treatment patterns, crude incidence rates (IRs) for exacerbations and mortality (per 100 person-years [PYs]; variable follow-up), and HCRU and costs (12-month follow-up) were summarized descriptively.</p><p><strong>Results: </strong>Of 4,920 patients in the TT cohort, mean (SD) age was 62.3 (9.7) years, 60.9% were female, and 68.0% were white; 46.5% of TT cohort patients with a history of smoking were current smokers. Hypertension (92.7%), ischemic heart disease (52.1%), and heart failure (40.1%) were the most prevalent cardiovascular comorbidities. Most patients received oral corticosteroids (89.6%) or antibiotics (92.8%) for exacerbation management during baseline. Add-on therapies included phosphodiesterase-4 inhibitors (10.4%) and leukotriene receptor antagonists (26.4%). During follow-up, IRs (95% CI) were 108.2 (104.7-111.8) per 100 PY for any moderate/severe exacerbation and 8.0 (7.4-8.6) per 100 PY for mortality. Exacerbation risk was similar by smoking status. During the 12-month follow-up, mean (SD) all-cause and COPD costs were $63,178 ($77,061) and $26,153 ($47,085), respectively.</p><p><strong>Conclusion: </strong>There is high mortality and considerable HCRU and healthcare costs incurred by people with COPD experiencing frequent moderate/severe exacerbations while on TT. Optimization of COPD management and new therapies are needed to reduce disease burden in this population.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1851-1864"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310638","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":"Hub Genes PRPF19 and PPIB: Molecular Pathways and Potential Biomarkers in COPD.","authors":"Jiale Zhao, Xiahui Ge, Hailong Li, Genfei Jing, Weirong Ma, Yuchun Fan, Juan Chen, Zhijun Zhao, Jia Hou","doi":"10.2147/COPD.S511696","DOIUrl":"10.2147/COPD.S511696","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD), a complex respiratory disorder, results from genetic and environmental factors. Uncovering its genetic basis is vital for diagnostics and treatment. Robust genetic analysis is essential to establish a causal link.</p><p><strong>Methods: </strong>Genome-wide DNA methylation analysis was performed using the Illumina Infinium HumanMethylation850 BeadChip in peripheral blood from 8 COPD patients and 8 healthy smoking controls. Differentially methylated genes (DMGs) were cross-analyzed with differentially expressed genes (DEGs) identified from the Gene Expression Omnibus (GEO) dataset GSE38974 (23 COPD, 9 controls). Weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) networks were utilized to identify COPD-associated hub genes. Mendelian randomization (MR) analysis examined the causal relationship between hub genes and COPD. The expression of selected hub genes was validated through RT-qPCR (80 COPD, 62 controls), immunohistochemistry, and Western blot analyses (10 COPD and 10 controls).</p><p><strong>Results: </strong>We found 10,593 DMGs and 646 DEGs associated with COPD. These genes were compared with WGCNA module genes, and the Protein-Protein Interaction (PPI) network interaction diagram was drawn, thereby identifying five Hub genes: PPIB, HSPA2, PRPF19, FKBP10 and DOHH. The expression levels of DOHH, FKBP10, PPIB and PRPF19 are higher in COPD, while the expression level of HSPA2 is lower. MR results indicate a potential causal relationship between PRPF19, PPIB and COPD. RT-qPCR, immunohistochemistry and Western blot experiments verified that the expression of PRPF-19 and PPIB was up-regulated in peripheral blood and lung tissue, which was consistent with the results of bioinformatics analysis.</p><p><strong>Conclusion: </strong>Our findings suggest that PRPF19 and PPIB may serve as promising diagnostic biomarkers in COPD. Further studies are required to fully elucidate their roles in COPD pathogenesis.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1865-1880"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310641","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":"FFMI: A Pivotal Indicator Bridging Pulmonary, Sleep, and Systemic Factors in COPD-OSA Overlap Patients.","authors":"Liang Wang, Ying-Ying Shen, Rui-Qi Qian, Xiu-Qin Zhang, Xu-Rui Shen, Cheng Chen","doi":"10.2147/COPD.S514400","DOIUrl":"10.2147/COPD.S514400","url":null,"abstract":"<p><strong>Objective: </strong>Overlap Syndrome (OVS), combining Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA), is common yet often unrecognized. This study aims to compare the Fat - Free Mass Index (FFMI) between OVS and simple COPD patients and analyze subgroup differences in OVS for better early identification and severity assessment.</p><p><strong>Methods: </strong>Clinical data of 364 patients (203 in COPD group, 161 in OVS group) were analyzed regarding clinical features, pulmonary function, sleep apnea, etc. The OVS group was divided into low-FFMI and normal-FFMI subgroups (the cutoff value of FFMI < 17kg/m²) for correlation analysis.</p><p><strong>Results: </strong>Statistically significant differences in frequency of acute exacerbations and hospitalizations in the past year, and comorbidities were observed between the COPD group and OVS group (all p < 0.05). The OVS group exhibited significantly lower FEV₁%pred, FEV₁ /FVC, 6MWT, FFMI, and L-SaO₂ compared to the COPD group (all p < 0.05), while AHI, ESS, CAT, and MMRC were higher. Patients with lower FFMI demonstrated lower FEV₁%pred, FEV₁/FVC, L-SaO2, and 6MWT than those with normal FFMI. Additionally, AHI, MMRC, frequency of acute exacerbations, and hospitalizations in the past year were higher (all p < 0.05) in this group. Correlation analysis revealed that in the OVS group, FFMI positively correlated with FEV1%pred and FEV1/FVC, and negatively with AHI, MMRC, exacerbation/hospitalization frequency.</p><p><strong>Conclusion: </strong>OVS patients had distinct features like more exacerbations, and lower lung function. The OVS subgroup with different FFMI showed significant differences in lung function and sleep indices. FFMI is closely related to pulmonary function, sleep disorder indices, and exacerbation frequency, suggesting its potential as an important indicator for early OVS identification and severity evaluation despite no significant difference in BMI.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1843-1849"},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310640","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":"Burden of Exacerbations in Patients Newly Initiating an Inhaled Regimen for COPD: A Claims Analysis.","authors":"Sanjay Sethi, Emily S Wan, Vickram Tejwani, Claudia Lamprey, Kavita Aggarwal, Amy Dixon, Yi Pan, Trishul Siddharthan","doi":"10.2147/COPD.S517864","DOIUrl":"10.2147/COPD.S517864","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive disease that has a great impact on healthcare resource utilization (HRU). Large-scale real-world evidence studies evaluating the clinical and economic impact of current maintenance inhaler therapies are scarce.</p><p><strong>Objective: </strong>To assess annual exacerbation rate and COPD-related HRU in patients with COPD before and after initiation of an inhaled treatment regimen.</p><p><strong>Methods: </strong>The Optum Clinformatics^® Data Mart database was used to identify inpatient, outpatient, and pharmacy claims from patients aged ≥40 years with COPD in the United States from January 2016 to June 2023. The index date was the date of the first prescription claim for a new inhaled maintenance therapy after a 12-month maintenance treatment-free baseline period. The primary outcome was the proportion of patients with ≥1 moderate/severe exacerbation within 12 months post-index. The average number of moderate/severe exacerbations per patient and the proportion of patients with inpatient, emergency department (ED), office, and outpatient visits within 12 months post-index were also assessed.</p><p><strong>Results: </strong>Of the 137,691 included patients, 51.5% were female and 74.6% were White, with a mean (standard deviation [SD]) age of 70.9 (9.49) years and a mean (SD) Elixhauser Comorbidity Index of 5.67 (3.29). Most (48.3%) patients were initiated on long-acting beta-agonists/inhaled corticosteroids (LABA/ICS). The proportions of patients with exacerbations significantly decreased overall (pre-index, 45.5%; post-index, 37.0%; <i>P</i> < 0.001). However, more than one-third of patients still experienced an exacerbation 12 months after initiating treatment. The proportion of patients with COPD-related HRU generally decreased; however, 5.0% and 2.9% of patients had inpatient and ED care post-index, respectively.</p><p><strong>Conclusion: </strong>Despite use of inhaled treatments for COPD, patients continue to experience exacerbations and HRU. Better implementation of guideline-based COPD care and novel therapies for persistent exacerbation burden are needed to improve care of the COPD population in real-world settings.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1829-1842"},"PeriodicalIF":2.7,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286911","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":"Unveiling the Role of Cathepsins on Lung Function in Chronic Obstructive Pulmonary Disease: A Mendelian Randomization Analysis.","authors":"Xuemin Zhang, Xintong Li, Shuang Song, Changhong Miao, Long Yan, Xiaolong Xu, Qingquan Liu","doi":"10.2147/COPD.S507283","DOIUrl":"10.2147/COPD.S507283","url":null,"abstract":"<p><strong>Background: </strong>Cathepsins are a group of proteases that can degrade the extracellular matrix of the lungs, leading to lung tissue destruction and remodeling in chronic obstructive pulmonary disease (COPD). However, the causal relationship between cathepsins and COPD remains unclear.</p><p><strong>Methods: </strong>We performed a two-sample Mendelian randomization (MR) analysis using genetic instruments for nine cathepsins (B, E, F, G, H, L2, O, S, and Z) and lung function measures (FVC, FEV1, FEV1/FVC, and PEF) in COPD. The MR analysis was conducted and reported as conducted and reported in accordance with the STROBE-MR Statement. We employed various MR methods and conducted sensitivity analyses to validate the results.</p><p><strong>Results: </strong>We found a significant association of cathepsin B with PEF (IVW beta = 0.016, 95% CI = 0.007 to 0.024, P = 2.83E-4), the FEV1/FVC ratio (IVW beta = 0.014, 95% CI = 0.004 to 0.023, P = 0.004), and FEV1 (IVW beta = 0.010, 95% CI = 0.002 to 0.018, P = 0.012) in COPD. These associations were consistent across different MR methods and robust to pleiotropy and heterogeneity. Multivariate MR analysis confirmed the independent effect of cathepsin B on lung function after adjusting for other cathepsins. Reverse MR analysis and colocalization analysis showed no evidence of reverse causality or shared genetic pathways with smoking.</p><p><strong>Conclusion: </strong>Our study suggested that elevated cathepsin B levels may reduce the risk of lung function decline in COPD. Targeting cathepsin B and its inhibitors could be a potential therapeutic strategy for COPD. Reduced serum levels of cathepsin B may serve as a biomarker of progressive decline in lung function in patients with COPD. However, further studies are needed to elucidate the underlying mechanisms and clinical implications of these findings.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1819-1828"},"PeriodicalIF":2.7,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276378","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":"Exercise Dysfunction and Pulmonary Rehabilitation Strategies in COPD Patients at High-Altitudes: A Review.","authors":"Lin-Xia Fan, Hong-Juan Wang","doi":"10.2147/COPD.S506552","DOIUrl":"10.2147/COPD.S506552","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) presents significant challenges for patients at high-altitudes, where reduced oxygen availability exacerbates exercise dysfunction. This review explores the related factors behind exercise limitations in high-altitude COPD patients, including chronic hypoxia, impaired pulmonary function, cardiovascular responses, muscle dysfunction, and psychological factors. Effective pulmonary rehabilitation (PR) strategies are essential and should encompass individualized assessments, tailored exercise programs, supplemental oxygen therapy, and nutritional and psychological support. This review highlights the need for further research to develop specific PR protocols for high-altitude COPD patients, focusing on long-term outcomes and innovative approaches to improve access to rehabilitation services. By addressing both physiological and psychological aspects, these strategies aim to enhance the quality of life and functional capacity of COPD patients in high-altitude environments.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1807-1817"},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267733","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":"Reasons for Hospital Admissions in Chronic Hypercapnic COPD Patients on Long-Term Nocturnal Noninvasive Ventilation - A Prospective Observational Study.","authors":"Simon Koschel, Sarah Bettina Stanzel, Doreen Kroppen, Marieke Duiverman, Maximilian Wollsching-Strobel, Daniel Majorski, Melanie Patricia Berger, Falk Schumacher, Johannes Fabian Holle, Wolfram Windisch, Maximilian Zimmermann","doi":"10.2147/COPD.S503742","DOIUrl":"10.2147/COPD.S503742","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive ventilation (NIV) is vital for managing chronic hypercapnic respiratory failure in COPD patients, yet the impact of handling issues like mask compliance triggering hospitalisations is often underestimated.</p><p><strong>Methods: </strong>A prospective, monocentric observational study was performed in COPD patients hospitalized for acute exacerbation with established home NIV therapy. Various questionnaires (CAT, SRI, BORG) and blood gas analysis were used to determine the severity and cause of respiratory insufficiency.</p><p><strong>Results: </strong>59 patients (mean age 66.57 years ± 9.42, mean BMI 26.99 ± 8.63) were included. 54.24% were female (n=32). The overall cohort had a mean exacerbation rate of 2.24 ± 1.48 within the last 12 months prior to admission. Patients were divided into 4 sub cohorts based on their exacerbation trigger: infection (n=25), handling problem (n=12), non-infection (n=8), and an overlap cohort with evidence of both handling problem and non-handling problem (n=14). Significant differences exist when comparing exacerbation rate (handling-issue cohort: 2.58 ± 1.68 vs infection cohort: 1.76 ± 1.13, p=0.043), total hospital stay (handling-issue cohort: 9.25 ± 5.94 days vs infection cohort: 12.96 ± 5.76 days, p=0.039). There was no significant difference in health-related quality of life measured by the SRI (Summary Score 40.6±12.3 vs 46.8±14.2; p=0.103).</p><p><strong>Discussion: </strong>In our study, we were able to show that handling problems are associated with frequent exacerbations, cause long hospitalisation periods and are associated with a reduced aspects of quality of life. Patient education and training should therefore play a key role in the treatment of patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1797-1806"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259205","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":"Quality of Care and Outcomes of Inpatients with COPD: A Multi-Center Study in China.","authors":"Fengyan Wang, Mingdie Wang, Xiaoyan Chen, Aiqi Song, Hui Zeng, Jiawei Chen, Lingwei Wang, Wanyi Jiang, Mei Jiang, Weijuan Shi, Yuqi Li, Heng Zhong, Rongchang Chen, Zhenyu Liang","doi":"10.2147/COPD.S510613","DOIUrl":"10.2147/COPD.S510613","url":null,"abstract":"<p><strong>Objective: </strong>Hospitalization due to chronic obstructive pulmonary disease (COPD) exacerbation is linked to worse prognosis and increased healthcare burden, especially in low- and middle-income countries. This study aimed to evaluate the quality of care and outcomes among inpatients with COPD and to identify prognostic factors relate to healthcare quality indicators.</p><p><strong>Methods: </strong>A multi-center, retrospective longitudinal study was conducted. Patients hospitalized for COPD exacerbations between January and December 2017 were randomly sampled from 16 secondary or tertiary public general hospitals in China. Healthcare quality process indicators and clinical outcomes were collected from medical records and patient questionnaires. The median follow-up period was 666 days. Multivariate logistic regression analysis was used to identify risk factors for readmission or death within 30 days after discharge and for one-year mortality.</p><p><strong>Results: </strong>A total of 891 inpatients with COPD were included. Among them, 14.3% underwent post-bronchodilator spirometry. Documentation of exacerbation history and symptom scores was found in 16.8% and 1.2% of medical records, respectively. Long-acting bronchodilators (LABDs) were prescribed at discharge in 30.3% of cases. Verbal counseling was the primary approach to smoking cessation education, rather than the 5A method. The 30-day readmission rate was 7.1%. The average exacerbation rate was 0.94 per patient during the following year, and the one-year mortality rate was 7.2%. Prescription of inhaled LABDs at discharge was significantly associated with a lower risk of readmission or death within 30 days (HR 0.51, 95% CI 0.29-0.90, p=0.020). The presence of cardiovascular disease was associated with an increased risk of death within one year (HR 2.34, 95% CI 1.24-4.41, p=0.002).</p><p><strong>Conclusion: </strong>The quality of inpatient care for COPD in China showed deficiencies in diagnostics, disease assessment, and patient education. Prescription of inhaled LABDs at discharge was a key quality measure that significantly reduced short-term readmission or mortality, highlighting its importance. Standardized protocols and clinician training are essential to improve patient outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1787-1795"},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227301","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":"Assessing Knowledge and Awareness of Asthma and Chronic Obstructive Pulmonary Disease Among the Iraqi Population.","authors":"Alaa Hussein Alsajri, Walid Al-Qerem, Anan Jarab, Dzul Azri Mohamed Noor, Shadan Waleed AlHishma, Ahmad Z Al Meslamani, Fawaz Alasmari, Alaa Hammad, Judith Eberhardt","doi":"10.2147/COPD.S517612","DOIUrl":"10.2147/COPD.S517612","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that result from persistent inflammation of the bronchial tubes. This study aimed to evaluate general attitudes and knowledge of Iraqi individuals towards asthma and COPD and to determine factors associated with higher knowledge levels, particularly considering the increase in pollution levels in developing countries.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted using a Google Forms questionnaire distributed across various social networking platforms. The questionnaire collected demographic data (age, gender, marital status, and economic status) alongside participants' knowledge about chronic respiratory diseases.</p><p><strong>Results: </strong>A total of 1033 Iraqi adults participated, 61% of whom were women. Most participants were non-smokers (82.4%) and did not report having chronic diseases (85.7%). Although majority demonstrated high levels of knowledge about COPD and asthma (68.8% and 59.8%, respectively). Nearly half of the participants believed that smoking is the main cause of asthma. Binary logistic regression analysis revealed that female gender, working in the medical field, and presence of chronic conditions were significantly associated with higher asthma knowledge levels (p < 0.05). While younger age, higher income levels, and working in the medical field were significantly associated with higher COPD knowledge levels (p < 0.05).</p><p><strong>Conclusion: </strong>This study showed that while most Iraqis possess good knowledge of chronic respiratory diseases, awareness remains limited and influenced by factors such as socioeconomic status. It is essential to conduct further research on awareness related to respiratory diseases and to develop incentive programs aimed at improving societal awareness.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1749-1760"},"PeriodicalIF":2.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209982","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}