Sang Hyuk Kim, Hye Yun Park, Hyun Lee, Hyewon Seo, Ji-Hyun Lee, Hyeon-Kyoung Koo, Na Young Kim, Kwang Ha Yoo, Ju Ock Na, Youlim Kim
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Among those patients with severe airflow limitation and those who used inhaled corticosteroids (ICS), incidence of progression was significantly higher. The risk factors for this progression were older age (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.19-3.34; per 10-year increase), decreased post-bronchodilator forced expiratory volume in 1 second (aOR = 1.32, 95% CI = 1.05-1.66; per 10% predicted decrease), increased blood eosinophil count (aOR = 1.21, 95% CI = 1.08-1.35; per 100 cells/μL increase), and use of ICS/long-acting beta-agonists (LABA) (aOR = 9.16, 95% CI = 1.38-60.82) and ICS/LABA/long-acting muscarinic antagonists (aOR = 8.00, 95% CI = 1.25-51.18).</p><p><strong>Conclusions: </strong>Among stable COPD patients, older age, decreased lung function, increased eosinophil counts, and use of ICS-containing inhalers were associated with progression to frequent exacerbators.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors for Progression to Frequent Exacerbators in Stable Patients with COPD.\",\"authors\":\"Sang Hyuk Kim, Hye Yun Park, Hyun Lee, Hyewon Seo, Ji-Hyun Lee, Hyeon-Kyoung Koo, Na Young Kim, Kwang Ha Yoo, Ju Ock Na, Youlim Kim\",\"doi\":\"10.4046/trd.2025.0058\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Little is known about the transition to frequent exacerbators in stabilized patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>This study utilized data obtained from the Korean COPD subgroup study cohort (KOCOSS), including 511 patients with infrequent exacerbations. The outcome for these groups was progression to frequent exacerbators. Multivariable logistic regression analysis was used to investigate the risk factors for progression.</p><p><strong>Results: </strong>Within one year, 40 patients (7.8%) progressed to frequent exacerbators. Among those patients with severe airflow limitation and those who used inhaled corticosteroids (ICS), incidence of progression was significantly higher. The risk factors for this progression were older age (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.19-3.34; per 10-year increase), decreased post-bronchodilator forced expiratory volume in 1 second (aOR = 1.32, 95% CI = 1.05-1.66; per 10% predicted decrease), increased blood eosinophil count (aOR = 1.21, 95% CI = 1.08-1.35; per 100 cells/μL increase), and use of ICS/long-acting beta-agonists (LABA) (aOR = 9.16, 95% CI = 1.38-60.82) and ICS/LABA/long-acting muscarinic antagonists (aOR = 8.00, 95% CI = 1.25-51.18).</p><p><strong>Conclusions: </strong>Among stable COPD patients, older age, decreased lung function, increased eosinophil counts, and use of ICS-containing inhalers were associated with progression to frequent exacerbators.</p>\",\"PeriodicalId\":23368,\"journal\":{\"name\":\"Tuberculosis and Respiratory Diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tuberculosis and Respiratory Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4046/trd.2025.0058\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tuberculosis and Respiratory Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4046/trd.2025.0058","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：对于稳定的慢性阻塞性肺疾病（COPD）患者向频繁加重剂的转变知之甚少。方法：本研究利用来自韩国COPD亚组研究队列（KOCOSS）的数据，包括511例罕见急性发作患者。这些组的结果是进展到频繁恶化。采用多变量logistic回归分析探讨进展的危险因素。结果：1年内，40例患者（7.8%）发展为频繁加重。在严重气流受限和使用吸入性皮质类固醇（ICS）的患者中，进展的发生率明显更高。这种进展的危险因素是年龄增大（调整优势比[aOR] = 1.99, 95%可信区间[CI] = 1.19-3.34；每10年增加）、支气管扩张剂后1秒用力呼气量减少（aOR = 1.32, 95% CI = 1.05-1.66；每10%预测减少）、血嗜酸性粒细胞计数增加(aOR = 1.21, 95% CI = 1.08-1.35；每100个细胞/μL增加)，使用ICS/长效β受体激动剂（LABA） （aOR = 9.16, 95% CI = 1.38 ~ 60.82）和ICS/LABA/长效毒蕈碱拮抗剂（aOR = 8.00, 95% CI = 1.25 ~ 51.18）。结论：在稳定期COPD患者中，年龄较大、肺功能下降、嗜酸性粒细胞计数增加和使用含ics的吸入器与频繁加重相关。
Risk factors for Progression to Frequent Exacerbators in Stable Patients with COPD.
Background: Little is known about the transition to frequent exacerbators in stabilized patients with chronic obstructive pulmonary disease (COPD).
Methods: This study utilized data obtained from the Korean COPD subgroup study cohort (KOCOSS), including 511 patients with infrequent exacerbations. The outcome for these groups was progression to frequent exacerbators. Multivariable logistic regression analysis was used to investigate the risk factors for progression.
Results: Within one year, 40 patients (7.8%) progressed to frequent exacerbators. Among those patients with severe airflow limitation and those who used inhaled corticosteroids (ICS), incidence of progression was significantly higher. The risk factors for this progression were older age (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.19-3.34; per 10-year increase), decreased post-bronchodilator forced expiratory volume in 1 second (aOR = 1.32, 95% CI = 1.05-1.66; per 10% predicted decrease), increased blood eosinophil count (aOR = 1.21, 95% CI = 1.08-1.35; per 100 cells/μL increase), and use of ICS/long-acting beta-agonists (LABA) (aOR = 9.16, 95% CI = 1.38-60.82) and ICS/LABA/long-acting muscarinic antagonists (aOR = 8.00, 95% CI = 1.25-51.18).
Conclusions: Among stable COPD patients, older age, decreased lung function, increased eosinophil counts, and use of ICS-containing inhalers were associated with progression to frequent exacerbators.
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