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. 2011 Aug;189(4):261-8.
doi: 10.1007/s00408-011-9301-8. Epub 2011 Jun 16.

Risk of nonlower respiratory serious adverse events following COPD exacerbations in the 4-year UPLIFT® trial

David M G Halpin  1 , Marc Decramer, Bartolome Celli, Steven Kesten, Inge Leimer, Donald P Tashkin
Affiliations

Risk of nonlower respiratory serious adverse events following COPD exacerbations in the 4-year UPLIFT® trial

David M G Halpin et al. Lung. 2011 Aug.

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) exacerbations are associated with systemic consequences. Data from a 4-year trial (Understanding Potential Long-term Impacts on Function with Tiotropium [UPLIFT(®)], n = 5,992) were used to determine risk for nonlower respiratory serious adverse events (NRSAEs) following an exacerbation.

Methods: Patients with ≥ 1 exacerbation were analyzed. NRSAE incidence rates (incidence rate [IR], per 100 patient-years) were calculated for the 30 and 180 days before and after the first exacerbation. NRSAEs were classified by diagnostic terms and organ classes. Maentel-Haenszel rate ratios (RR) (pre- and postexacerbation onset) along with 95% confidence intervals (CI) were computed.

Results: A total of 3,960 patients had an exacerbation. The mean age was 65 years, forced expiratory volume in 1 s (FEV(1)) was 38% predicted, and 74% were men. For all NRSAEs, the IRs 30 days before and after an exacerbation were 20.2 and 65.2 with RR (95% CI) = 3.22 (2.40-4.33). The IRs for the 180-day periods were 13.2 and 31.0 with RR (95% CI) = 2.36 (1.93-2.87). The most common NRSAEs by organ class for both time periods were cardiac, respiratory system (other), and gastrointestinal. All NRSAEs as well as cardiac events were more common after the first exacerbation, irrespective of whether the patient had cardiac disease at baseline.

Conclusions: The findings confirm that, after exacerbations, serious adverse events in other organ systems are more frequent, particularly those that are cardiac in nature.

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References

    1. Spencer S, Jones PW. Time course of recovery of health status following an infective exacerbation of chronic bronchitis. Thorax. 2003;58:589–593. doi: 10.1136/thorax.58.7.589. - DOI - PMC - PubMed
    1. Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157(5 Pt 1):1418–1422. - PubMed
    1. Donaldson GC, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002;57:847–852. doi: 10.1136/thorax.57.10.847. - DOI - PMC - PubMed
    1. Seemungal TA, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161:1608–1613. - PubMed
    1. Price LC, Lowe D, Hosker HS, Anstey K, Pearson MG, Roberts CM, British Thoracic Society and the Royal College of Physicians Clinical Effectiveness Evaluation Unit (CEEu) UK National COPD Audit 2003: impact of hospital resources and organisation of care on patient outcome following admission for acute COPD exacerbation. Thorax. 2006;61:837–842. doi: 10.1136/thx.2005.049940. - DOI - PMC - PubMed

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