Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med.2023, 12, 6695.
Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med. 2023, 12, 6695.
Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med.2023, 12, 6695.
Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med. 2023, 12, 6695.
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.
Keywords
COPD; Exacerbation; Primary health care; Risk factors; Prediction; recurrent exacerbations
Subject
Medicine and Pharmacology, Pulmonary and Respiratory Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.