International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"The Role and Clinical Significance of Vitamin D in Chronic Obstructive Pulmonary Disease.","authors":"Mengqing Sun, Yang Qian, Chenting Cai, Jiaqian Zhang, Ruonan Qi, Hongying Ma, Qunli Ding, Shanshan Wang, Dan Lv","doi":"10.2147/COPD.S520795","DOIUrl":"10.2147/COPD.S520795","url":null,"abstract":"<p><p>Vitamin D is well known for its role in bones, but it also has a variety of extra-skeletal effects. Vitamin D deficiency is becoming a global health problem. Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world, resulting in an enormous medical and economic burden. Accumulating evidence indicates a high prevalence of vitamin D deficiency in patients with COPD, which has emerged as a significant modulator of disease progression. This comprehensive review systematically examines the multifactorial etiology of vitamin D deficiency in COPD, encompassing insufficient sunlight exposure, malnutrition, smoking, comorbidities, and chronic inflammatory states. Clinical observational studies have demonstrated significant associations between vitamin D deficiency and increased exacerbation frequency, accelerated lung function decline, and elevated mortality risk. Mechanistically, we elucidate the pleiotropic effects of vitamin D in COPD pathogenesis, including its anti-inflammatory activity, suppression of oxidative stress, modulation of innate and adaptive immunity, inhibition of hepcidin, and reduction in pulmonary infection risk. Building on current evidence, we critically evaluate the clinical efficacy of various vitamin D supplementation strategies. This review aims to provide clinicians with an evidence-based framework for incorporating vitamin D assessment and supplementation into comprehensive COPD management while also identifying key directions for future research.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2023-2033"},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530569","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":"Withholding of Life-Sustaining Treatment and Mortality in ICU Patients with Severe Acute COPD Exacerbations: A Retrospective French Cohort.","authors":"Pauline Puechoultres, Matthieu Jamme, Georges Abi-Abdallah, Sylvain Diop, Stéphane Legriel, Alexis Ferré","doi":"10.2147/COPD.S502019","DOIUrl":"10.2147/COPD.S502019","url":null,"abstract":"<p><strong>Background: </strong>Data on withholding life-support (WLS) decisions during acute exacerbations of chronic obstructive pulmonary disease (COPD) in the intensive care unit (ICU) are scarce. This study aimed to identify factors associated with these decisions and their impact on mortality.</p><p><strong>Methods: </strong>We conducted a monocentric retrospective cohort study on all patients admitted to our ICU between 2015 and 2021 for a severe acute exacerbation of COPD. Logistic multivariable regression analysis was performed.</p><p><strong>Results: </strong>We included 463 patients of whom 128 (27.6%) had a decision of withholding of care. The 3-months mortality was 49.2% and 4.8% in the WLS group and in the no WLS group, respectively. Forty-eight patients (10.4%) had advanced healthcare directives. In multivariable analysis, factors associated with a decision of WLS were higher age (odds ratio [+10 years] = 1.93, <i>p</i> < 0.001), immunodeficiency (OR = 3.07, <i>p</i> < 0.001), higher Performance Status (PS) score (OR [+1 point] = 2.10, <i>p</i> < 0.001), long-term oxygen therapy (OR = 4.11, <i>p</i> < 0.001) and shock after ICU admission (OR = 2.43, <i>p</i> = 0.01). In multivariate analysis, factors significantly associated with 3-month mortality included decision of WLS during ICU (OR = 22.98, <i>p</i> < 0.001) and invasive mechanical ventilation (OR = 2.72, p < 0.001).</p><p><strong>Conclusion: </strong>Approximately 30% of COPD patients underwent a decision to withhold life-sustaining treatment. Higher age, immunosuppression, increased PS score, and long-term oxygen therapy were significantly associated with this decision. Nearly half of the patients died within three months following a withholding of care decision.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1995-2009"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477512","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":"Dual Use of Electronic Cigarettes and Cigarettes Elevates Risk of Chronic Obstructive Pulmonary Disease and Mental Health Issues: Insights from a Korean Health Survey.","authors":"Chi Young Kim, Sang Ho Park, Yeseul Seong, Yong Jun Choi, Hye Jung Park, Jae Hwa Cho, Min Kwang Byun","doi":"10.2147/COPD.S524978","DOIUrl":"10.2147/COPD.S524978","url":null,"abstract":"<p><strong>Purpose: </strong>Significant differences exist between the toxicity and adverse outcomes of conventional cigarettes and electronic cigarettes. However, spirometry-based clinical outcome analyses in the general population have not been widely studied. This study aimed to investigate the factors associated with electronic cigarette use among individuals with different smoking status and pulmonary function test results.</p><p><strong>Patients and methods: </strong>This study was conducted in Korea using data from the Korean National Health and Nutrition Examination Survey from 2013 to 2019. Participants who reported baseline clinical information, including smoking status, and underwent a pulmonary function test, were included.</p><p><strong>Results: </strong>In total, 19,356 participants, including current smokers, former smokers, and participants who never smoked, participated in this study. Among the participants who smoked, 5.7% reported current electronic cigarette use, including dual users (who use conventional cigarettes and electronic cigarettes). Factors associated with e-cigarette use included male sex, younger age, higher education level, higher household income, and being current or former heavy smoker. Additionally, cigarette users had the highest prevalence of chronic obstructive pulmonary disease, followed by dual users and electronic cigarette-only users (<i>P</i> < 0.001). Furthermore, individuals with anxiety and depression were significantly more prevalent among dual users than among those who had never smoked (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This study indicates an association between e-cigarette use and individual factors, including sex, age, education level, and income level. Electronic cigarette use, including dual use, is associated with chronic obstructive pulmonary disease. Additionally, anxiety and depression were highest among dual users, followed by those among conventional cigarette users.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1973-1981"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477459","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":"Paradigm Shift in the Treatment of Chronic Obstructive Pulmonary Disease Improves Patient Outcomes.","authors":"Yi-Jen Huang, Kwua-Yun Wang, Wu-Chien Chien, Chi-Hsiang Chung, Li-Ting Kao, Senyeong Kao, Chih-Feng Chian","doi":"10.2147/COPD.S511593","DOIUrl":"10.2147/COPD.S511593","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the real-world impact of LAMA+LABA combination therapy on COPD outcomes, bridging the gap between experimental data and clinical practice. It aims to assess whether the paradigm shift in the treatment of chronic obstructive pulmonary disease has improved patient outcomes, particularly in terms of acute exacerbations, hospitalizations, and mortality, while providing insights to guide clinical and policy decisions.</p><p><strong>Patients and methods: </strong>This retrospective study analyzes cohorts derived from outpatient and inpatient medical records from Taiwan's National Health Insurance Research Database. It includes individuals diagnosed with COPD in two periods: 2012-2014 and 2016-2018.</p><p><strong>Results: </strong>The paradigm shift in COPD treatment has led to a significant transition in medication selection, moving away from single-agent or supplementary inhaled corticosteroid (ICS) regimens (from 99.61% to 20.99%) towards the use of dual bronchodilators or triple therapy (from 0.38% to 79.02%). The analysis between long-acting muscarinic antagonists (LAMAs) and long-acting beta-agonists (LABAs) revealed no statistically significant differences in emergency department visits and hospitalizations. However, LABAs were associated with a notable reduction in all-cause mortality compared to LAMAs (aHR 0.674-0.765). Additionally, the widespread adoption of dual bronchodilator therapy and the implementation of precise guidelines for ICS use have led to significant reductions in emergency department visits (aHR 0.557-0.735), decreased hospitalizations (aHR 0.610-0.725), and improved mortality outcomes (aHR 0.226-0.294) among COPD patients.</p><p><strong>Conclusion: </strong>The paradigm shift in treatment approaches has led to substantial improvements in patient outcomes for COPD, regardless of the treatment regimen employed. This development marks a significant advancement in enhancing both the efficacy and precision of COPD management.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1965-1972"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477460","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 Impact of Gut Microbiota on Chronic Obstructive Pulmonary Disease: A Dual-Sample Mendelian Randomization Study.","authors":"Na Niu, Jian Zhao, Haoxiang Li, Yongen Miao, Futao Chen, Junyong Liu, Limin Cao, Tuo Ji, Feng Gao, Shuanshuan Xie, Yunfeng Zhang","doi":"10.2147/COPD.S511383","DOIUrl":"10.2147/COPD.S511383","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a major cause of global mortality and disability. Previous research suggests a relationship between gut microbiota and COPD, yet the causal link remains unclear. Hence, we conducted a dual-sample Mendelian randomization study to elucidate the impact of gut microbiota on COPD.</p><p><strong>Methods: </strong>We utilized single-nucleotide polymorphisms (SNPs) as instrumental variables, and the Inverse Variance Weighted (IVW) method for primary analysis. We explored the causal linkage between gut microbiota species (Coprococcus2, Holdemanella, Allisonella, Anaerostipes, Lachnospiraceae UCG008, Lachnospiraceae UCG010, Prevotella9, Marvinbryantia, Ruminococcaceae UCG013) and COPD through the analysis of genome-wide association study (GWAS) data sourced from a Finnish database. Summary data for COPD (6,915 cases and 186,723 controls), Early onset COPD (3,508 cases and 212,197 controls), admission rate of COPD (9,113 cases and 212,292 controls), related infection of COPD (59,925 cases and 159,867 controls), respiratory dysfunction of COPD (1,031 cases and 186,723 controls), were from FinnGen consortium R7 GWAS.</p><p><strong>Result: </strong>Our analysis revealed statistically significant correlations between several genera and COPD. Coprococcus2 exhibits a consistent protective role throughout the progression of COPD, evident in both typical COPD [OR=0.750, 95% CI (0.601-0.937)], early-onset cases [OR=0.686, 95% CI (0.511-0.920)], COPD-related hospitalizations [OR=0.724, 95% CI (0.575-0.910)] and infections [OR=0.301, 95% CI (0.094-0.961)]. Holdemanella manifests as a consistent risk factor in the COPD incidence [OR=1.211, 95% CI (1.063-1.380)], early-onset COPD [OR=1.214, 95% CI (1.019-1.446)], COPD hospitalization [OR=1.225, 95% CI (1.072-1.401)] and respiratory impairment (OR:1.645, 95% CI: 1.198-2.258). Allisonella demonstrates protective attributes in COPD occurrence [OR=0.884, 95% CI (0.794-0.984)]. Genera such as Anaerostipes, Lachnospiraceae UCG008, Lachnospiraceae UCG010, and Prevotella9 show protective effects specifically in early-onset COPD. Marvinbryantia and Ruminococcaceae UCG013 are consistently identified as risk factors in onset of typical COPD.</p><p><strong>Conclusion: </strong>Mendelian randomization studies confirm a causal link between gut microbiota and various COPD types and complications, offering new insights into the disease's pathogenesis, prevention, and treatment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1983-1993"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477461","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":"Influence of Urinary Incontinence Related Factors on Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.","authors":"Nada Saleh Alrajhi, Ali Albarrati, Monira I Aldhahi, Rehab F M Gwada","doi":"10.2147/COPD.S515494","DOIUrl":"10.2147/COPD.S515494","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition marked by airflow limitation and symptoms like chronic cough, breathlessness, and chest tightness. These factors, along with exacerbations and polypharmacy, may predispose COPD patients to urinary incontinence (UI). Unique challenges such as increased intra-abdominal pressure, pelvic floor weakness, and comorbidities may worsen UI and impair health-related quality of life (HRQoL). This study aimed to identify factors associated with UI severity in COPD patients and to examine its impact on HRQoL.</p><p><strong>Methods: </strong>This cross-sectional study included 101 participants diagnosed with COPD who were reported to have UI. Participants completed the following questionnaires: the health status and UI severity were recorded using the COPD Assessment Test (CAT), International Consultation on Incontinence Questionnaire- Urinary Incontinence - short form (ICIQ-UI short form), and Incontinence Impact Questionnaire - short form (IIQ-7).</p><p><strong>Results: </strong>UI severity was correlated with age, BMI, smoking, comorbidities, medications, chest tightness, and breathlessness. Severe UI predictors included age (OR=1.07), BMI (OR=1.09), and number of medications (OR=5.04), whereas breathlessness predicted moderate (OR=1.72) and severe UI (OR=1.87). Among COPD patients, 82.2% reported a mild impact of UI on HRQoL, and 6.9% reported a severe impact. Notably, among those experiencing moderate-to-severe HRQoL impairment, 63.6% had severe UI.</p><p><strong>Conclusion: </strong>This study highlights urinary incontinence (UI) as a prevalent and impactful comorbidity in individuals with COPD, significantly affecting their HRQoL. UI severity was associated with clinical factors such as older age, higher body mass index (BMI), greater medication burden, and breathlessness. Notably, greater UI severity corresponded to more substantial impairments in HRQoL, with severe cases reporting greater negative effects on daily functioning. These findings underscore the importance of routine screening for UI in COPD patients and the implementation of targeted continence care strategies to enhance overall quality of life.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1881-1892"},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318418","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":"A Systematic Review and Meta-Analysis on the Safety and Efficacy of Rosuvastatin as an Adjunctive Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease.","authors":"Wei Wei An, Le Ting Zheng, Fei Dong, Xiao Ning Zhong","doi":"10.2147/COPD.S513918","DOIUrl":"10.2147/COPD.S513918","url":null,"abstract":"<p><strong>Purpose: </strong>Acute exacerbations of chronic obstructive pulmonary disease (COPD) severely impact patient health, and current treatments often fail to adequately control inflammation and lung function decline. Statins have shown potential in managing AECOPD. This study conducts a systematic review and meta-analysis to evaluate the effects of rosuvastatin, aiming to provide precise treatment recommendations.</p><p><strong>Research methods: </strong>Using \"Pulmonary Disease, Chronic Obstructive\" and \"Rosuvastatin Calcium\" as MeSH terms, randomized controlled trials (RCTs) evaluating the efficacy and safety of rosuvastatin in AECOPD patients were retrieved from databases including PubMed, EMBASE, the Cochrane Library, Sinomed, CNKI, WanFang Data, and QIVIP. The search period extended through September 15, 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.3 software, while sensitivity analyses and publication bias tests were conducted with Stata 17.0.</p><p><strong>Results: </strong>Eleven RCTs involving 911 patients were included, with a certain risk of bias. Rosuvastatin was found to improve forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and peak expiratory flow (PEF). Additionally, it significantly reduced levels of hs-CRP, TNF-α, IL-6, IL-8, NE, and Gal-3.</p><p><strong>Conclusion: </strong>Despite the limited number of studies and potential bias, evidence suggests that rosuvastatin improves lung function and reduces inflammation in AECOPD, underscoring its potential value and emphasizing the need for further high-quality research.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1939-1954"},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318415","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 C-Reactive Protein to Lymphocyte Ratio and Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.","authors":"Ting Ao, Yingxiu Huang, Peng Zhen, Ming Hu","doi":"10.2147/COPD.S510755","DOIUrl":"10.2147/COPD.S510755","url":null,"abstract":"<p><strong>Background: </strong>The inflammatory response plays a critical role in the progression and prognosis of Chronic Obstructive Pulmonary Disease (COPD). The C-reactive protein to lymphocyte ratio (CLR) has emerged as a potential novel biomarker of systemic inflammation. Nevertheless, the association between CLR and COPD remains unclear. The objective of this study was to explore the possible connection between CLR and COPD.</p><p><strong>Methods: </strong>We conducted a retrospective study on 22,581 participants from the NHANES dataset (1999-2010). To evaluate the relationship between CLR and COPD, logistic regression analysis, restricted cubic spline analysis, and threshold effect analysis were utilized. Furthermore, subgroup and sensitivity analyses were conducted to assess the robustness of the identified association.</p><p><strong>Results: </strong>Multivariate logistic regression models indicated that the ln-transformed CLR was significantly associated with an increased risk of COPD (OR: 1.14, 95% CI: 1.04-1.25; P = 0.005). Compared to participants classified with the first tertile of ln-transformed CLR (T1), the risks of COPD for those in T2 and T3 were 1.03 and 1.33 times higher, respectively. An evident upward trend was noted with an increase in the ln-transformed CLR (P for trend =0.032). Furthermore, an inverse L-shaped association was identified between the ln-transformed CLR and the risk of COPD. The robustness and consistency of these findings were further confirmed by subgroup and sensitivity analyses.</p><p><strong>Conclusion: </strong>Increased CLR correlated with a heightened risk of developing COPD, exhibiting nonlinear patterns and threshold effects.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1915-1925"},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318416","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 of Patient-Reported Outcome Patterns and Major Clinical Factors with Frailty in Stable COPD.","authors":"Mengjiao Yang, Ziwei Wang, Yangyang Zhao, Jie He, Dier Lin, Yali Wang, Yang Liu","doi":"10.2147/COPD.S517270","DOIUrl":"10.2147/COPD.S517270","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) exhibits heterogeneous symptom profiles across individuals. This study aimed to identify subgroups of patients with stable COPD according to physiological, psychological, and environmental symptoms; assess differences in their characteristics; and examine the association of symptom patterns with frailty.</p><p><strong>Patients and methods: </strong>We analyzed data from the second wave of a cohort study involving patients with COPD reassessed 6 months after hospitalization for acute exacerbations. Frailty and patient-reported outcomes were measured using the FRAIL and Modified COPD-Patient-Reported Outcome (mCOPD-PRO) scales. Latent profile analysis identified subgroups based on mCOPD-PRO symptom patterns. Differences across symptom severity subgroups were assessed using post-hoc trend analyses and chi-square tests for trends. Multinomial logistic regression quantified the magnitude of differences between subgroups. The relationship between subgroups, clinical factors, and frailty was examined through linear regression.</p><p><strong>Results: </strong>Among 308 patients with stable COPD, three subgroups were identified: \"low-symptom\" (27.9%), \"moderate-symptom\" (51.3%), and \"severe-symptom\" (20.8%). Body mass index, Global Initiative for Chronic Obstructive Lung Disease stage (GOLD), COPD Assessment Test (CAT) score, modified Medical Research Council (mMRC) score, and physical activity exhibited significant linear trends across subgroups of increasing symptom severity. Frailty scores differed significantly: 0.50 ± 0.78 in the low-symptom group, 1.34 ± 0.96 in the moderate-symptom group, and 2.72 ± 0.95 in the severe-symptom group. Multivariate analysis identified severe-symptom group (β coefficient [β]=0.62, 95% confidence interval [CI]: 0.21-1.03), rural residence (β=0.21, 95% CI: 0.04-0.39), GOLD (β=0.23, 95% CI: 0.07-0.39), mMRC (β=0.17, 95% CI: 0.03-0.31), and CAT score (β=0.04, 95% CI: 0.02-0.06) associated with frailty.</p><p><strong>Conclusion: </strong>Patients with stable COPD can be categorized based on patient-reported outcomes, with differences in demographic and disease characteristics across subgroups. Patients with severe COPD symptoms revealed higher levels of frailty compared to those with low symptoms.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1927-1937"},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318417","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":"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}