Thoracic research and practice最新文献

{"title":"Turkish Thoracic Society Declaration on Peace and Health the Importance of Breathing in a World Without War.","authors":"Pelin Duru Çetinkaya, Zehra Nur Töreyin, Hande Yüce Özdemir, Yeşim Yasin, Oğuz Kılınç, Arzu Yorgancıoğlu, Haluk C Çalışır, Çağlar Çuhadaroğlu, Nurdan Köktürk, Ezgi Demirdöğen, Nesrin Öcal, Züleyha Bingöl, Aslı Gürün Kaya, Dorina Esendağlı, Ethem Yıldız, Mehmet Baran Balcan, Barış Çil, Hacıali Kılıçgün, Erencan Begiç","doi":"10.4274/ThoracResPract.2026.2026-1-6","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-6","url":null,"abstract":"<p><p>War legitimizes the right to kill for its participants, equating victory with moral justification; however, this perceived legitimacy is largely constructed on the deaths of civilians and other living beings. Medicine, by its very nature, is grounded in the principles of preserving life, doing no harm, and adhering to scientific and ethical standards, and is therefore fundamentally opposed to the philosophy of war. Wars lead, directly and indirectly, to deaths, disability, displacement, poverty, and long-term public health disasters. Attacks on health facilities, restrictions on access to food and water, environmental destruction, and air pollution disproportionately affect vulnerable populations, particularly women and children. The psychological consequences of war often evolve into persistent neuropsychiatric conditions, including post-traumatic stress disorder, depression, and moral injury. Peace is not merely the absence of war; it is a prerequisite for health, environmental sustainability, and social well-being. The concept of positive peace strengthens health indicators through well-functioning institutions, equitable resource distribution, and the protection of human rights. Within this framework, health professionals and civil society organizations are critical actors in advocating for peace and in making human rights violations visible. The Turkish Thoracic Society regards peace as an indispensable condition for public and respiratory health, affirms its opposition to all wars-particularly the ongoing atrocities in Gaza-and reaffirms its commitment to sustained, health-based advocacy for peace.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 1","pages":"68-74"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking: The New 9^th Version TNM Classification for Lung Cancer is Now in Use","authors":"Yusuf Kahya, Feride Marım, Gökçen Ömeroğlu Şimşek, Haydar Soydaner Karakuş, Sevin Başer Öncel, Müge Meltem Tor, Tuncay Göksel","doi":"10.4274/ThoracResPract.2025.2025-2-6","DOIUrl":"10.4274/ThoracResPract.2025.2025-2-6","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related mortality worldwide. Among the parameters determining prognosis in lung cancer, the stage of the disease holds primary importance. Staging provides a universally accepted terminology for describing the anatomical characteristics of cancer, facilitating reliable communication in clinical research, evaluation of treatment outcomes, and prognosis. The tumor, node, metastasis (TNM) staging system, developed by the American Joint Committee on Cancer (AJCC) and the International Union for Cancer Control (UICC), serves as a simple, practical, and globally recognized staging framework. Over the past two decades, the International Association for the Study of Lung Cancer has been conducting a global three-phase project aimed at revising the TNM classification. The first two phases of this project were focused on revising the 7^th and 8^th lung cancer TNM staging revisions under the guidance of AJCC and the UICC. The third and final phase, the 9^th staging project, has been completed and has been implemented as of January 1, 2025. This review aims to examine the 9^th version of the TNM staging system compared to previous versions and evaluate the structural modifications, statistical foundations, and clinical implications of the new system. In the study, current data regarding the 9^th version of the TNM staging system have been analysed; the revisions made to the T, N, and M components are detailed; the fundamental changes between the 8^th and 9^th versions are compared using tables. Furthermore, the impacts of the staging system on daily clinical practice are discussed.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"47-56"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Pleural Diseases: Current Applications and Next Steps.","authors":"Ferhan Karataş, Öner Dikensoy","doi":"10.4274/ThoracResPract.2025.2025-6-2","DOIUrl":"10.4274/ThoracResPract.2025.2025-6-2","url":null,"abstract":"<p><p>Pleural diseases pose a significant burden on healthcare systems due to diagnostic challenges and high costs. Artificial intelligence (AI) has the potential to provide faster, more accurate, and more reliable results in the diagnosis of these diseases. This review evaluates the current status of AI technologies in the diagnosis of pleural effusion (PE), malignant PE, tuberculosis pleurisy (TP), pneumothorax, and malignant pleural mesothelioma (MPM). Deep learning algorithms developed for radiological diagnosis provide high sensitivity and specificity in determining the presence and severity of PE. AI models that integrate clinical parameters such as chest computed tomography (CT), positron emission tomography (PET)-CT, and tumour markers in distinguishing between benign and malignant effusions have significantly improved diagnostic accuracy (area under the curve: >0.90). In cytological diagnosis, computer-assisted systems such as Aitrox have demonstrated performance comparable to that of expert cytopathologists in diagnosing malignant effusions. In the diagnosis of TP, AI models outperform conventional diagnostic methods, particularly when combined with laboratory parameters such as adenosine deaminase. Food and Drug Administration-approved AI models are effectively used for the rapid diagnosis of pneumothorax and for emergency interventions. In MPM diagnosis, AI models using PET-CT images and three-dimensional segmentation offer significant advantages in prognostic evaluation and treatment response monitoring. However, large-scale, multi-centre studies are needed to standardise and generalise AI models. In light of these developments, AI may fundamentally change the diagnostic management of pleural diseases.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"57-67"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI in Patient Care: Evaluating Large Language Model Performance Against Evidence-Based Guidelines for Pulmonary Embolism.","authors":"Ömer F Karakoyun, Halil E Koyuncuoğlu, Ömer H Sağnıç, Mehmed E Özdemir, Yalçın Gölcük, Birdal Yıldırım","doi":"10.4274/ThoracResPract.2025.2025-6-3","DOIUrl":"10.4274/ThoracResPract.2025.2025-6-3","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI)-driven large language models (LLMs) are increasingly used in patient education; however, their ability to interpret and apply clinical guidelines within real-world physician workflows remains uncertain. Pulmonary embolism (PE), with its well-established diagnostic and management protocols, provides a suitable model for evaluating these systems. This study assessed the performance of four widely used AI-driven LLMs-ChatGPT-4o, DeepSeek-V2, Gemini, and Grok-in applying the 2019 European Society of Cardiology guidelines for PE. The focus was on evaluating clinical accuracy, adherence to guidelines, and response consistency.</p><p><strong>Material and methods: </strong>Ten open-ended questions based on a simulated PE case were created, covering diagnosis, risk stratification, treatment, and follow-up. Guideline-based reference answers were used for scoring. LLMs were tested under identical conditions, and the responses were anonymized and scored by two emergency physicians using a 10-point scale. Inter-rater reliability was measured using the intraclass correlation coefficient (ICC), and group comparisons were made using Kruskal-Wallis tests.</p><p><strong>Results: </strong>ChatGPT-4o scored highest (76), followed by Gemini (73.75), Grok (71.25), and DeepSeek-V2 (65). No significant difference was found in total scores (<i>P</i> = 0.390). Performance varied by category; ChatGPT-4o excelled in follow-up, while DeepSeek-V2 performed best in diagnostics. Expert reviewers noted ChatGPT-4o's structured responses and Grok's practicality, but highlighted limitations such as insufficient personalization and guideline gaps. Inter-rater agreement was excellent (ICC: 0.986).</p><p><strong>Conclusion: </strong>AI-driven LLMs show promise in supporting PE management, though none consistently excel in all domains. Further development is needed to enhance clinical integration and guideline compliance.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"38-46"},"PeriodicalIF":0.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Much Do We Know About Acute Kidney Injury Following Pneumonectomy? A Retrospective Study.","authors":"Çiğdem Yıldırım Güçlü, Süheyla Karadağ Erkoç, Bengi Şafak, Yusuf Kahya, Süleyman Gökalp Güneş, Başak Ceyda Meco","doi":"10.4274/ThoracResPract.2025.2025-7-9","DOIUrl":"10.4274/ThoracResPract.2025.2025-7-9","url":null,"abstract":"<p><strong>Objective: </strong>Acute kidney injury (AKI) is a significant postoperative complication of thoracic surgery, but data on AKI after pneumonectomy remain scarce. This study aimed to determine the incidence, risk factors, and short-term outcomes of AKI, as defined by Kidney Disease Improving Global Outcomes 2012 criteria, occurring within one week after pneumonectomy.</p><p><strong>Material and methods: </strong>This retrospective single-center cohort included adults who underwent elective pneumonectomy between 2008-2018. Patients with preoperative chronic kidney disease or AKI, or with missing data, were excluded. Demographic, perioperative, and postoperative data were collected from hospital records. AKI was identified based on postoperative creatinine values measured within one week. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.</p><p><strong>Results: </strong>Of the 308 patients, 166 met the inclusion criteria. The incidence of AKI was 12% (19 stage 1, 1 stage 2); none required renal replacement therapy. In multivariate analysis, increased body mass index [odds ratio (OR): 1.10, 95% confidence interval (CI): 1.01-1.21, <i>P</i> = 0.038]; acetylsalicylic acid use (OR: 10.56, 95% CI: 1.58-70.60, <i>P</i> = 0.015); higher intraoperative fluid volume (OR: 1.00, 95% CI: 1.00-1.00, <i>P</i> = 0.036); and length of stay (OR: 1.07, 95% CI: 1.01-1.13, <i>P</i> = 0.016) were associated with increased AKI risk, while nonsteroidal anti-inflammatory drug use was independently protective (OR: 0.03, 95% CI: 0.00-0.13, <i>P</i> < 0.001), as was diuretic use (OR: 0.06, 95% CI: 0.01-0.50, <i>P</i> = 0.009). AKI was associated with longer hospitalization but not with increased mortality.</p><p><strong>Conclusion: </strong>Reducing the incidence of AKI may improve patient outcomes, and AKI should be considered a key quality indicator in thoracic surgery. Identifying and understanding the risk factors for AKI may provide the foundation for predictive models and guide strategies to prevent this complication.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 1","pages":"21-29"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the First Impact Factor: Editorial Renewal and Direction in Thoracic Research and Practice.","authors":"Metin Akgün, Begüm Ergan","doi":"10.4274/ThoracResPract.2026.2026.230126","DOIUrl":"10.4274/ThoracResPract.2026.2026.230126","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 1","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Necessity of Bronchiectasis Registries - The Turkish Registry of Bronchiectasis.","authors":"Deniz Kızılırmak, Miguel Angel Martinez-Garcia, Sedat Çiçek, Ayşın Şakar Coşkun, Oğuz Kılınç, Ebru Çakır Edis","doi":"10.4274/ThoracResPract.2025.2025-5-4","DOIUrl":"10.4274/ThoracResPract.2025.2025-5-4","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"75-76"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should the Mandatory Health Referral System be Implemented in Türkiye? A Perspective from a Tertiary Pulmonology Hospital.","authors":"Hülya Abalı, Fatma Tokgöz Akyıl","doi":"10.4274/ThoracResPract.2025.2025-6-5","DOIUrl":"10.4274/ThoracResPract.2025.2025-6-5","url":null,"abstract":"<p><strong>Objective: </strong>Providing care at the appropriate level is key to cost-effective healthcare. In Türkiye, a mandatory referral system has not yet been implemented. This study aimed to determine the proportion of cases presented to a tertiary outpatient clinic that genuinely required tertiary-level care and to analyze their characteristics compared with those better suited for management at lower levels of care.</p><p><strong>Material and methods: </strong>This observational study included 692 patients (mean age: 54±15 years; 51% male) who attended two pulmonologists' outpatient clinics. Data on demographics, reasons for application, and all institutions to which individuals applied (primary, secondary, tertiary) for chest conditions within the previous 12 months were collected. After clinical evaluations, the appropriate level of care for each case was assessed.</p><p><strong>Results: </strong>Overall, 70.2% (n = 486) of cases bypassed primary care. While 10.7% (n = 74) required tertiary-level care, 66.3% (n = 459) required secondary-level care. Emergency departments (30%, n = 208) were visited more frequently than family physicians (29.6%, n = 205). Among cases seen in primary care, 11% were referred to higher-level care. The most common diagnoses were asthma and chronic obstructive pulmonary disease (56.8%; n = 394). While 46% (n = 318) of all cases received prescriptions or follow-up, 18.6% (n = 129) required interventions. Among the cases, 70.1% avoided non-teaching public hospitals, while 15% (n = 104) made more than 10 return visits to the study hospital.</p><p><strong>Conclusion: </strong>Approximately 70% of cases presenting to a tertiary pulmonology center could have been managed at lower levels of care. Healthcare policymakers should urgently implement sustainable solutions to address the factors that impede the referral chain.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 1","pages":"30-37"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excessive Short-acting Beta-agonists Prescriptions in COPD Treated with Triple Inhaler Therapy: A Possible Marker of Frequent Exacerbations. A Retrospective Cohort Study.","authors":"Bruno Sposato, Leonardo Gianluca Lacerenza, Elisa Petrucci, Alberto Ricci, Alberto Cresti, Pasquale Baratta, Andrea Serafini, Claudio Micheletto, Maurizio Di Tomassi, Antonio Perrella, Valerio Alonzi, Sara Croce, Marco Scalese","doi":"10.4274/ThoracResPract.2025.2025-6-1","DOIUrl":"10.4274/ThoracResPract.2025.2025-6-1","url":null,"abstract":"<p><strong>Objective: </strong>Short-acting β2-agonists (SABA) are used both in asthma and in chronic obstructive pulmonary disease (COPD); SABA use appears to be associated with an increased risk of exacerbations. We evaluated whether COPD patients receiving regular treatment with single-inhaler triple therapy (SITT) used SABA and whether they experienced more exacerbations.</p><p><strong>Material and methods: </strong>Our single-center cohort study retrospectively included COPD patients who had been on SITT for 12 months and who were prescribed >7 inhaled corticosteroids/long-acting β2-agonists/long-acting muscarinic antagonist packages. Patients were divided into three groups based on the number of SABA boxes they received during the SITT year: no SABA (0 boxes/year), 1-2 boxes/year, and ≥3 boxes/year. Oral corticosteroids (OC) and antibiotic packs during the SITT year were considered outcomes for the SABA groups.</p><p><strong>Results: </strong>Five thousand one hundred and seven subjects were recruited, and 1,444 (28.3%) had at least one SABA prescription. Adherence to SITT treatment was similar across the three SABA groups: 10.7±2.8, 10.6±2.8, and 10.9±3.9 packages/year in the 0, 1-2, and ≥3 SABA groups, respectively. The number of OC/antibiotic packages increased progressively across SABA groups from 0 to 1-2 and ≥3 (<i>P</i> < 0.0001). When we applied logistic models, we also observed a progressively higher risk of taking OC and antibiotics among subjects who had taken 1-2 packs of SABA [odds ratio (OR): 2.299 (1.878-2.813) and 2.034 (1.621-2.551), respectively; <i>P</i> < 0.0001], and among those who had taken ≥3 packs of SABA [OR: 3.472 (2.871-4.200) and 2.714 (2.192-3.362), respectively; <i>P</i> < 0.0001].</p><p><strong>Conclusion: </strong>A significant number of subjects were prescribed SABA despite SITT therapy. A relationship between SABA packages and the number of exacerbations, assessed by OC/antibiotic prescriptions, was observed. Excessive SABA use or prescription may indicate frequent exacerbations in patients with COPD despite receiving maximal inhaled therapy.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"3-10"},"PeriodicalIF":0.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expiratory Muscle Strength, Peak Oxygen Consumption and Hyperinflation Predicts Severe Exacerbation in Chronic Obstructive Pulmonary Disease Patients.","authors":"Mahima Mayee Tripathy, Aqsa Mujaddadi, Obaidullah Ahmed, Deepak Talwar","doi":"10.4274/ThoracResPract.2025.2025-6-6","DOIUrl":"10.4274/ThoracResPract.2025.2025-6-6","url":null,"abstract":"<p><strong>Objective: </strong>To explore the predictive ability of physiological and clinical parameters, including respiratory muscle strength, peak oxygen consumption, exercise capacity assessed by the six-minute walk distance (6MWD), pulmonary function, and arterial blood gas for identifying patients with chronic obstructive pulmonary disease (COPD) who are at risk of frequent severe acute exacerbations.</p><p><strong>Material and methods: </strong>This retrospective, observational study analyzed data from 265 patients who were hospitalized for severe exacerbations between January 1^st, 2018 to February 28^th,, 2024. Patients were classified as infrequent or frequent exacerbators based on the annual frequency of severe exacerbations. Binary logistic regression models were used to identify independent predictors, adjusting for clinically relevant covariates.</p><p><strong>Results: </strong>In adjusted multivariate analysis, maximal expiratory pressure [odds ratio (OR): 0.989; 95% confidence interval (CI): 0.980-0.998; <i>P</i> = 0.014], 6MWD (OR: 0.997; 95% CI: 0.994-1.000; <i>P</i> = 0.028), 6MWD% (OR: 0.985; 95% CI: 0.970-0.999; <i>P</i> = 0.041), peak oxygen consumption (OR: 0.874; 95% CI: 0.776-0.986; <i>P</i> = 0.028), residual volume (OR: 1.006; 95% CI: 1.001-1.011; <i>P</i> = 0.017), and functional residual capacity (OR: 1.008; 95% CI: 1.001-1.014; <i>P</i> = 0.028) emerged as significant predictors of frequent severe exacerbations.</p><p><strong>Conclusion: </strong>Expiratory muscle weakness, reduced peak oxygen consumption, diminished exercise capacity, and pulmonary hyperinflation are independent predictors of frequent severe acute exacerbations in patients with COPD. Incorporating these parameters into routine assessments may enhance risk stratification and goal-directed therapies, and potentially reduce hospitalization rates.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 1","pages":"11-20"},"PeriodicalIF":0.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}