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. 2023 May 15;9(3):00569-2022.
doi: 10.1183/23120541.00569-2022. eCollection 2023 May.

Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients

Carmen Reumkens  1 , Adrian Endres  2 , Sami O Simons  3 , Paul H M Savelkoul  1 , Roy T M Sprooten  4   5 , Frits M E Franssen  3   6   5
Affiliations

Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients

Carmen Reumkens et al. ERJ Open Res. .

Abstract

Background: Recently, the Rome classification was proposed in which objective and readily measurable variables were integrated to mark exacerbations of COPD (ECOPD) severity. The aim of this study is to investigate the distribution of a real-world patient population with hospitalised ECOPD according to the current classification across the newly proposed severity classification. We assume that a significant proportion of hospitalised patients will have a mild or moderate event.

Methods: The Rome classification was applied to a cohort of 364 COPD patients hospitalised at the Department of Respiratory Medicine of Maastricht University Medical Center (MUMC) with a severe ECOPD. Differences in in-hospital, 30- and 90-day mortality were compared between mild, moderate and severe ECOPD according to the new classification. Moreover, data were stratified by the different severity classes and compared regarding general disease characteristics and clinical parameters.

Results: According to the Rome proposal, 52 (14.3%) patients had a mild ECOPD, 204 (56.0%) a moderate and 108 (29.7%) a severe ECOPD. In-hospital mortality in mild, moderate and severe events was 3.8%, 6.9% and 13.9%, respectively. Most clinical parameters indicated a significantly worse condition in patients classified in the severe group, compared to those in mild or moderate groups.

Conclusion: Most of the events, traditionally all classified as severe because of the hospitalisation, were classified as moderate, while almost 15% were mild. The results of this study provide insight into the heterogeneity of hospitalised ECOPD and show that the newly proposed Rome criteria can differentiate between events with different short-term mortality rates.

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Conflict of interest statement

Conflict of interest: A. Endres has received grants from Frankfurter Arbeitskreis Pneumologie und Allergologie, Mukoviszidose e.V., and European Cystic Fibrosis Society, outside the submitted work; support for attending conference received from Insmed, outside the submitted work. Conflict of interest: S.O. Simons has received grants or contracts from AstraZeneca, GlaxoSmithKline and Boehringer Ingelheim, outside the submitted work; consulting fees from GlaxoSmithKline, outside the submitted work; honoraria received from AstraZeneca and Chiesi for lectures outside the submitted work; support for attending meetings from Chiesi, outside the submitted work; honoraria for advisory board for Chiesi and Boehringer Ingelheim, outside the submitted work. Conflict of interest: P.H.M. Savelkoul received a grant from Eurostar, outside the submitted work. Conflict of interest: F.M.E. Franssen received grants or contracts from AstraZeneca, outside the submitted work; payment or honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Chiesi and Novartis, outside the submitted work; and support for attending meetings and/or travel from Chiesi outside the submitted work. Conflict of interest: The remaining authors have nothing to disclose.

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