Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 7;20(1):318.
doi: 10.1186/s12890-020-01362-w.

Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease

Hiroki Tashiro  1 , Yuki Kurihara  1 , Koichiro Takahashi  2 , Hironori Sadamatsu  1 , Tetsuro Haraguchi  1 , Ryo Tajiri  3 , Ayako Takamori  3 , Shinya Kimura  1 , Naoko Sueoka-Aragane  1
Affiliations

Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease

Hiroki Tashiro et al. BMC Pulm Med. .

Abstract

Background: Exacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established.

Methods: The present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n = 88, 18.3%) and those who never experienced severe exacerbation (n = 393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n = 27, 30.7%) and infrequent exacerbators (1 time/year, n = 61, 69.3%).

Results: Compared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 s and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12-1.88], p < 0.01).

Conclusion: Blood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations.

Trial registration: The patients in this study was registered retrospectively.

Keywords: Blood eosinophil; Exacerbation; Frequency.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Halpin DMG, Celli BR, Criner GJ, Frith P, Lopez Varela MV, Salvi S, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis. 2019;23(11):1131–1141. doi: 10.5588/ijtld.19.0397. - DOI - PubMed
    1. Soler N, Torres A, Ewig S, Gonzalez J, Celis R, El-Ebiary M, et al. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation. Am J Respir Crit Care Med. 1998;157(5 Pt 1):1498–1505. doi: 10.1164/ajrccm.157.5.9711044. - DOI - PubMed
    1. Viegi G, Maio S, Pistelli F, Baldacci S, Carrozzi L. Epidemiology of chronic obstructive pulmonary disease: health effects of air pollution. Respirology. 2006;11(5):523–532. doi: 10.1111/j.1440-1843.2006.00886.x. - DOI - PubMed
    1. Hasegawa W, Yamauchi Y, Yasunaga H, Sunohara M, Jo T, Matsui H, et al. Factors affecting mortality following emergency admission for chronic obstructive pulmonary disease. BMC Pulm Med. 2014;14:151. doi: 10.1186/1471-2466-14-151. - DOI - PMC - PubMed
    1. Suzuki M, Makita H, Ito YM, Nagai K, Konno S, Nishimura M, et al. Clinical features and determinants of COPD exacerbation in the Hokkaido COPD cohort study. Eur Respir J. 2014;43(5):1289–1297. doi: 10.1183/09031936.00110213. - DOI - PubMed