Risk Factors for Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Industrial Regions of China: A Multicenter Cross-Sectional Study

Abstract

Background: The exacerbation of chronic obstructive pulmonary disease (COPD) seriously affects the patient's quality of life and prognosis. This multicenter cross-sectional study investigated the characteristics of stable COPD and risk factors for acute exacerbation of COPD (AECOPD) in patients in Changchun, Jilin Province, China.

Methods: The study included 400 outpatients admitted to four secondary hospitals and four tertiary hospitals in Jilin Province from March 2018 to March 2019. Data on the general condition of stable COPD patients, patient self-management, COPD Assessment Test (CAT) scores, number of acute exacerbations in the past 12 months, and medications received during the study period were collected using a questionnaire.

Results: Sociodemographic characteristics and clinical data were obtained from 306 patients, and drug prescription data were obtained from 329 patients. Pearson correlation analysis revealed that CAT scores were positively correlated with the number of acute exacerbations. Age, education level, smoking history, disease duration, number of comorbidities, and the presence of ischemic heart disease (IHD) were associated with AECOPD. Moreover, the level of education, disease duration, and the presence of IHD were independent risk factors for AECOPD. Poor compliance due to the lack of understanding of the disease and the high cost of treatment is a risk factor for AECOPD. In addition, increased air pollution in industrial cities and vitamin D deficiency are closely related to AECOPD.

Conclusion: Low education level, long disease duration, and the presence of IHD may promote the exacerbation and poor control of COPD in patients in Jilin Province.

Keywords: COPD; Jilin Province; exacerbation; risk factors.

Figure 1

Association of CAT scores with the number of acute exacerbations of chronic obstructive pulmonary disease in the past 12 months.

Figure 2

Monthly average cost of diagnosis and treatment of chronic obstructive pulmonary disease (COPD) in patients from groups A, B, and D. (group A, COPD Assessment Test [CAT] score <10, number of acute COPD exacerbations in the past 12 months ≤1, and no hospitalizations; group B, CAT score ≥10, number of acute COPD exacerbations in the past 12 months ≤1, and no hospitalizations; group D, CAT score ≥10, number of acute COPD exacerbations in the past 12 months ≥2, and hospitalizations).