| Title: |
Exacerbation Burden in COPD and Occurrence of Mortality in a Cohort of Italian Patients: Results of the Gulp Study |
| Authors: |
Santus P.; Di Marco F.; Braido F.; Contoli M.; Corsico A. G.; Micheletto C.; Pelaia G.; Radovanovic D.; Rogliani P.; Saderi L.; Scichilone N.; Tanzi S.; Vella M.; Boarino S.; Sotgiu G.; Solidoro P. |
| Contributors: |
Santus, P.; Di Marco, F.; Braido, F.; Contoli, M.; Corsico, A.G.; Micheletto, C.; Pelaia, G.; Radovanovic, D.; Rogliani, P.; Saderi, L.; Scichilone, N.; Tanzi, S.; Vella, M.; Boarino, S.; Sotgiu, G.; Solidoro, P. |
| Publisher Information: |
Dove Medical Press Ltd |
| Publication Year: |
2024 |
| Collection: |
IRIS Università degli Studi di Palermo |
| Subject Terms: |
heart failure; ischaemic heart disease; public health; pulmonary disease chronic obstructive; respiratory medicine; Settore MEDS-07/A - Malattie dell'apparato respiratorio |
| Description: |
Objective: To describe the burden of moderate to severe exacerbations and all-cause mortality; the secondary objectives were to analyze treatment patterns and changes over follow-up. Design: Observational, multicenter, retrospective, cohort study with a three year follow-up period. Setting: Ten Italian academic secondary-and tertiary-care centers. Participants: Patients with a confirmed diagnosis of COPD referring to the outpatient clinics of the participating centers were retrospectively recruited. Primary and Secondary Outcome Measures: Annualized frequency of moderate and severe exacerbations stratified by exacerbation history prior to study enrollment. Patients were classified according to airflow obstruction, GOLD risk categories, and divided in 4 groups: A = no exacerbations; B = 1 moderate exacerbation; C = 1 severe exacerbation; D = ≥2 moderate and/or severe exacerbations. Overall all-cause mortality stratified by age, COPD category, and COPD therapy. A logistic regression model assessed the association of clinical characteristics with mortality. Results: 1111 patients were included (73% males), of which 41.5% had a history of exacerbations. As expected, the proportion of patients experiencing ≥1 exacerbation during follow-up increased according to pre-defined study risk categories (B: 79%, C: 84%, D: 97.4%). Overall, by the end of follow-up, 45.5% of patients without a history of exacerbation experienced an exacerbation (31% of which severe), and 13% died. Deceased patients were significantly older, more obstructed and hyperinflated, and more frequently active smokers compared with survivors. Severe exacerbations were more frequent in patients that died (23.5%, vs 10.2%; p-value: 0.002). Chronic heart failure and ischemic heart disease were the only comorbidities associated with a higher odds ratio (OR) for death (OR: 2.2, p-value: 0.001; and OR: 1.9, p-value: 0.007). Treatment patterns were similar in patients that died and survivors. Conclusion: Patients with a low exacerbation risk are exposed to a ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/wos/WOS:001180104900001; volume:19; firstpage:607; lastpage:617; numberofpages:11; journal:INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE; https://hdl.handle.net/10447/698929 |
| DOI: |
10.2147/COPD.S446636 |
| Availability: |
https://hdl.handle.net/10447/698929; https://doi.org/10.2147/COPD.S446636 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.869E82E0 |
| Database: |
BASE |