Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.

Jorgen Vestbo; Hana Müllerova; Diego J Maselli; Nicholas Locantore; John R Hurst; Yavor Ivanov; Kosta Kostov; Jean Bourbeau; Mark Fitzgerald; Paul Hernández; Kieran Killian; Robert Levy; Francois Maltais; Denis O Donnell; Jan Krepelka; Jørgen Vestbo; Dean Quinn; Per Bakke; Mitja Kosnik; Alvar Agusti; Yuri Feschenko; Volodymyr Gavrisyuk; Lyudmila Yashina; William MacNee; S David Singh; Jadwiga Wedzicha; Antonio Anzueto; Sidney Braman; Richard Casaburi; Bart Celli; Glenn Giessel; Mark Gotfried; Gary Greenwald; Nicola Hanania; Don Mahler; Barry Make; Stephen Rennard; Carolyn Rochester; Paul Scanlon; Dan Schuller; Frank Sciurba; Amir Sharafkhaneh; Thomas Siler; Edwin Silverman; Adam Wanner; Robert Wise; Richard Zu Wallack; Harvey Coxson; Lisa Edwards; David Lomas; Ruth Tal-Singer; Julie Yates; Peter Calverley; Bartolome Celli; Courtney Crim; Bruce Miller; Emiel Wouters

doi:10.1378/chest.14-0655

Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.

Jorgen Vestbo, Hana Müllerova, Diego J Maselli, Nicholas Locantore, John R Hurst, Yavor Ivanov (Collaborator), Kosta Kostov (Collaborator), Jean Bourbeau (Collaborator), Mark Fitzgerald (Collaborator), Paul Hernández (Collaborator), Kieran Killian (Collaborator), Robert Levy (Collaborator), Francois Maltais (Collaborator), Denis O Donnell (Collaborator), Jan Krepelka (Collaborator), Jørgen Vestbo (Collaborator), Dean Quinn (Collaborator), Per Bakke (Collaborator), Mitja Kosnik (Collaborator), Alvar Agusti (Collaborator)Yuri Feschenko (Collaborator), Volodymyr Gavrisyuk (Collaborator), Lyudmila Yashina (Collaborator), William MacNee (Collaborator), S David Singh (Collaborator), Jadwiga Wedzicha (Collaborator), Antonio Anzueto (Collaborator), Sidney Braman (Collaborator), Richard Casaburi (Collaborator), Bart Celli (Collaborator), Glenn Giessel (Collaborator), Mark Gotfried (Collaborator), Gary Greenwald (Collaborator), Nicola Hanania (Collaborator), Don Mahler (Collaborator), Barry Make (Collaborator), Stephen Rennard (Collaborator), Carolyn Rochester (Collaborator), Paul Scanlon (Collaborator), Dan Schuller (Collaborator), Frank Sciurba (Collaborator), Amir Sharafkhaneh (Collaborator), Thomas Siler (Collaborator), Edwin Silverman (Collaborator), Adam Wanner (Collaborator), Robert Wise (Collaborator), Richard Zu Wallack (Collaborator), Harvey Coxson (Collaborator), Lisa Edwards (Collaborator), David Lomas (Collaborator), Ruth Tal-Singer (Collaborator), Julie Yates (Collaborator), Peter Calverley (Collaborator), Bartolome Celli (Collaborator), Courtney Crim (Collaborator), Bruce Miller (Collaborator), Emiel Wouters (Collaborator)

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N = 2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history of exacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airflow limitation, poorer health status, older age, radiologic evidence of emphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P <.001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airflow limitation and are a significant prognostic factor of reduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airflow limitation, poor health status, age, presence of emphysema, and leukocytosis. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00292552; URL: www.clinicaltrials.gov.

Original language	English
Journal	Chest
Volume	147
Issue number	4
DOIs	https://doi.org/10.1378/chest.14-0655
Publication status	Published - Apr 2015

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10.1378/chest.14-0655

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Vestbo, J., Müllerova, H., Maselli, D. J., Locantore, N., Hurst, J. R., Ivanov, Y., Kostov, K., Bourbeau, J., Fitzgerald, M., Hernández, P., Killian, K., Levy, R., Maltais, F., O Donnell, D., Krepelka, J., Vestbo, J., Quinn, D., Bakke, P., Kosnik, M., ... Wouters, E. (2015). Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort. Chest, 147(4). https://doi.org/10.1378/chest.14-0655

@article{faa87f8b74244764a8b8d98c6f4fb3e8,

title = "Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.",

abstract = "OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N = 2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history of exacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airflow limitation, poorer health status, older age, radiologic evidence of emphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P <.001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airflow limitation and are a significant prognostic factor of reduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airflow limitation, poor health status, age, presence of emphysema, and leukocytosis. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00292552; URL: www.clinicaltrials.gov.",

author = "Jorgen Vestbo and Hana M{\"u}llerova and Maselli, {Diego J} and Nicholas Locantore and Hurst, {John R} and Yavor Ivanov and Kosta Kostov and Jean Bourbeau and Mark Fitzgerald and Paul Hern{\'a}ndez and Kieran Killian and Robert Levy and Francois Maltais and {O Donnell}, Denis and Jan Krepelka and J{\o}rgen Vestbo and Dean Quinn and Per Bakke and Mitja Kosnik and Alvar Agusti and Yuri Feschenko and Volodymyr Gavrisyuk and Lyudmila Yashina and William MacNee and Singh, {S David} and Jadwiga Wedzicha and Antonio Anzueto and Sidney Braman and Richard Casaburi and Bart Celli and Glenn Giessel and Mark Gotfried and Gary Greenwald and Nicola Hanania and Don Mahler and Barry Make and Stephen Rennard and Carolyn Rochester and Paul Scanlon and Dan Schuller and Frank Sciurba and Amir Sharafkhaneh and Thomas Siler and Edwin Silverman and Adam Wanner and Robert Wise and {Zu Wallack}, Richard and Harvey Coxson and Lisa Edwards and David Lomas and Ruth Tal-Singer and Julie Yates and Peter Calverley and Bartolome Celli and Courtney Crim and Bruce Miller and Emiel Wouters",

note = "G0800570, Medical Research Council, United Kingdom",

year = "2015",

month = apr,

doi = "10.1378/chest.14-0655",

language = "English",

volume = "147",

journal = "Chest",

issn = "1931-3543",

publisher = "Elsevier BV",

number = "4",

}

Vestbo, J, Müllerova, H, Maselli, DJ, Locantore, N, Hurst, JR, Ivanov, Y, Kostov, K, Bourbeau, J, Fitzgerald, M, Hernández, P, Killian, K, Levy, R, Maltais, F, O Donnell, D, Krepelka, J, Vestbo, J, Quinn, D, Bakke, P, Kosnik, M, Agusti, A, Feschenko, Y, Gavrisyuk, V, Yashina, L, MacNee, W, Singh, SD, Wedzicha, J, Anzueto, A, Braman, S, Casaburi, R, Celli, B, Giessel, G, Gotfried, M, Greenwald, G, Hanania, N, Mahler, D, Make, B, Rennard, S, Rochester, C, Scanlon, P, Schuller, D, Sciurba, F, Sharafkhaneh, A, Siler, T, Silverman, E, Wanner, A, Wise, R, Zu Wallack, R, Coxson, H, Edwards, L, Lomas, D, Tal-Singer, R, Yates, J, Calverley, P, Celli, B, Crim, C, Miller, B & Wouters, E 2015, 'Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.', Chest, vol. 147, no. 4. https://doi.org/10.1378/chest.14-0655

TY - JOUR

T1 - Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.

AU - Vestbo, Jorgen

AU - Müllerova, Hana

AU - Maselli, Diego J

AU - Locantore, Nicholas

AU - Hurst, John R

A2 - Ivanov, Yavor

A2 - Kostov, Kosta

A2 - Bourbeau, Jean

A2 - Fitzgerald, Mark

A2 - Hernández, Paul

A2 - Killian, Kieran

A2 - Levy, Robert

A2 - Maltais, Francois

A2 - O Donnell, Denis

A2 - Krepelka, Jan

A2 - Vestbo, Jørgen

A2 - Quinn, Dean

A2 - Bakke, Per

A2 - Kosnik, Mitja

A2 - Agusti, Alvar

A2 - Feschenko, Yuri

A2 - Gavrisyuk, Volodymyr

A2 - Yashina, Lyudmila

A2 - MacNee, William

A2 - Singh, S David

A2 - Wedzicha, Jadwiga

A2 - Anzueto, Antonio

A2 - Braman, Sidney

A2 - Casaburi, Richard

A2 - Celli, Bart

A2 - Giessel, Glenn

A2 - Gotfried, Mark

A2 - Greenwald, Gary

A2 - Hanania, Nicola

A2 - Mahler, Don

A2 - Make, Barry

A2 - Rennard, Stephen

A2 - Rochester, Carolyn

A2 - Scanlon, Paul

A2 - Schuller, Dan

A2 - Sciurba, Frank

A2 - Sharafkhaneh, Amir

A2 - Siler, Thomas

A2 - Silverman, Edwin

A2 - Wanner, Adam

A2 - Wise, Robert

A2 - Zu Wallack, Richard

A2 - Coxson, Harvey

A2 - Edwards, Lisa

A2 - Lomas, David

A2 - Tal-Singer, Ruth

A2 - Yates, Julie

A2 - Calverley, Peter

A2 - Celli, Bartolome

A2 - Crim, Courtney

A2 - Miller, Bruce

A2 - Wouters, Emiel

N1 - G0800570, Medical Research Council, United Kingdom

PY - 2015/4

Y1 - 2015/4

N2 - OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N = 2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history of exacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airflow limitation, poorer health status, older age, radiologic evidence of emphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P <.001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airflow limitation and are a significant prognostic factor of reduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airflow limitation, poor health status, age, presence of emphysema, and leukocytosis. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00292552; URL: www.clinicaltrials.gov.

AB - OBJECTIVE: Exacerbations of COPD requiring hospital admission have important clinical and societal implications. We sought to investigate the incidence, recurrence, risk factors, and mortality of patients with COPD exacerbations requiring hospital admission compared with those without hospital admission during 3-year follow-up. Patients with COPD (N = 2,138) were identified from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) observational cohort. METHODS: An analysis of time to first event of hospital admission was performed using Kaplan-Meier curves and Cox proportional hazard regression adjusting for possible confounders. RESULTS: Of the 2,138 patients, 670 (31%) reported a total of 1,452 COPD exacerbations requiring hospital admission during the study period; 313 patients (15%) reported multiple events. A prior history of exacerbation of COPD requiring hospital admission was the factor associated with the highest risk of a new hospitalization for exacerbation (hazard ratio, 2.71; 95% CI, 2.24-3.29; P <.001). Other risk factors included more severe airflow limitation, poorer health status, older age, radiologic evidence of emphysema, and higher WBC count. Having been hospitalized for exacerbation significantly increased the risk of mortality (P <.001). CONCLUSIONS: Exacerbations of COPD requiring hospital admission occur across all stages of airflow limitation and are a significant prognostic factor of reduced survival across all COPD stages. Patients with COPD at a high risk for hospitalization can be identified by their past history for similar events, and other factors, including the severity of airflow limitation, poor health status, age, presence of emphysema, and leukocytosis. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00292552; URL: www.clinicaltrials.gov.

U2 - 10.1378/chest.14-0655

DO - 10.1378/chest.14-0655

M3 - Article

C2 - 25356881

SN - 1931-3543

VL - 147

JO - Chest

JF - Chest

IS - 4

ER -

Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort.

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