ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
Search Tips:
- Use the keyword search to search by keyword or author's name.
- Filter your search results by selecting the checkboxes that apply.
- Click on "Clear" to clear the form and start a new search. .
Search results will display below the form.
Routinely Collected Clinical Features Are Associated with COPD Exacerbations in Individuals Without an Exacerbation History: A COPDGene Analysis
Session Title
TP41 - TP041 DIAGNOSIS AND RISK ASSESSMENT IN COPD
Abstract
A2293 - Routinely Collected Clinical Features Are Associated with COPD Exacerbations in Individuals Without an Exacerbation History: A COPDGene Analysis
Author Block: M. Ferrera1, C. L. Lopez2, S. Murray2, R. G. Jain3, W. W. Labaki1, B. J. Make4, M. K. Han1; 1Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, United States, 2Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States, 3GlaxoSmithKline, Research Triangle Park, NC, United States, 4Division of Pulmonary, Critical Care & Sleep Medicine, Natl Jewish Health, Denver, CO, United States.
RATIONALE: Respiratory exacerbations in COPD are detrimental events associated with increased mortality and morbidity, accelerated FEV1 decline, and elevated healthcare costs. History of prior exacerbations is the strongest risk factor for future exacerbations. In patients with COPD but without a history of exacerbations in the previous year, risk factors associated with future exacerbations are not fully understood. We aimed to identify routinely collected clinical features that could easily assess risk of future exacerbation in low-risk COPD patients.
METHODS: COPDGene participants with COPD, no exacerbations in the year prior to their five-year study visit, and at least one longitudinal follow-up encounter in the subsequent 3 years were included in the analysis. Exacerbations were collected every 6 months based on telephony or web-based follow-up. Univariable and (post-hoc) multivariable zero-inflated negative binomial regression models evaluated factors associated with exacerbations in the subsequent 3 years. Both moderate and severe exacerbations were included in the analyses.
RESULTS: 1,528 participants were included in this analysis. The mean age of participants was 69.0 years with the majority being male (58.1%) and former smokers (66.3%). Mean FEV1 %predicted was 65.5%. 33.2% of participants (n=508) had at least one moderate or severe exacerbation during follow-up. In univariable analysis, history of gastroesophageal reflux (GERD) (rate ratio (RR) 1.26, 95% CI [1.02, 1.56], p=0.03), chronic bronchitis (RR 1.64, 95% CI [1.30, 2.08], P<0.001), and Modified Medical Research Council Dyspnea Score (mMRC) ≥ 2 (RR 1.99, 95% CI [1.62, 2.46], p<0.001) were associated with a significantly increased rate of exacerbations over 3 years. All three remained significant in a multivariable model controlling for age, sex, smoking status, and FEV1 %predicted (GERD, RR 1.33, 95% CI [1.07, 1.65], p=0.009; chronic bronchitis, RR 1.68, 95% CI [1.32, 2.15], p<0.001; mMRC ≥ 2, RR 1.67, 95% CI [1.34, 2.09], p<0.001).
CONCLUSIONS: Among COPD patients without history of exacerbation in the previous year, three readily available features—GERD, chronic bronchitis, and mMRC ≥ 2—are associated with a significantly increased rate of exacerbations over 3 years.
Author Block: M. Ferrera1, C. L. Lopez2, S. Murray2, R. G. Jain3, W. W. Labaki1, B. J. Make4, M. K. Han1; 1Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, United States, 2Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States, 3GlaxoSmithKline, Research Triangle Park, NC, United States, 4Division of Pulmonary, Critical Care & Sleep Medicine, Natl Jewish Health, Denver, CO, United States.
RATIONALE: Respiratory exacerbations in COPD are detrimental events associated with increased mortality and morbidity, accelerated FEV1 decline, and elevated healthcare costs. History of prior exacerbations is the strongest risk factor for future exacerbations. In patients with COPD but without a history of exacerbations in the previous year, risk factors associated with future exacerbations are not fully understood. We aimed to identify routinely collected clinical features that could easily assess risk of future exacerbation in low-risk COPD patients.
METHODS: COPDGene participants with COPD, no exacerbations in the year prior to their five-year study visit, and at least one longitudinal follow-up encounter in the subsequent 3 years were included in the analysis. Exacerbations were collected every 6 months based on telephony or web-based follow-up. Univariable and (post-hoc) multivariable zero-inflated negative binomial regression models evaluated factors associated with exacerbations in the subsequent 3 years. Both moderate and severe exacerbations were included in the analyses.
RESULTS: 1,528 participants were included in this analysis. The mean age of participants was 69.0 years with the majority being male (58.1%) and former smokers (66.3%). Mean FEV1 %predicted was 65.5%. 33.2% of participants (n=508) had at least one moderate or severe exacerbation during follow-up. In univariable analysis, history of gastroesophageal reflux (GERD) (rate ratio (RR) 1.26, 95% CI [1.02, 1.56], p=0.03), chronic bronchitis (RR 1.64, 95% CI [1.30, 2.08], P<0.001), and Modified Medical Research Council Dyspnea Score (mMRC) ≥ 2 (RR 1.99, 95% CI [1.62, 2.46], p<0.001) were associated with a significantly increased rate of exacerbations over 3 years. All three remained significant in a multivariable model controlling for age, sex, smoking status, and FEV1 %predicted (GERD, RR 1.33, 95% CI [1.07, 1.65], p=0.009; chronic bronchitis, RR 1.68, 95% CI [1.32, 2.15], p<0.001; mMRC ≥ 2, RR 1.67, 95% CI [1.34, 2.09], p<0.001).
CONCLUSIONS: Among COPD patients without history of exacerbation in the previous year, three readily available features—GERD, chronic bronchitis, and mMRC ≥ 2—are associated with a significantly increased rate of exacerbations over 3 years.
