Factors associated with prolonged duration of AECOPD:Analysis of the ECLIPSE cohort

Abstract

Prolonged duration of AECOPD may be associated with poorer outcomes. We evaluated factors associated with duration of AECOPD in the ECLIPSE cohort. The ECLIPSE observational cohort study included patients with COPD(GOLD grades II-IV). We analysed data from patients who experienced ≥1 moderate/severe AECOPD during the 3-year study. Exacerbations were classified as moderate (treated with OCS and/or antibiotics) or severe (requiring hospitalisation). Only the first exacerbation was considered in the analysis. Duration(days) of AECOPD was calculated as the end date minus the start date for each exacerbation plus one, with start and end dates obtained directly from the patient/physician report. We used explanatory, logistic regression modelling to identify factors associated with prolonged exacerbation duration, defined as >22 days (75thpercentile). Overall, 1,554 patients experienced ≥1 exacerbations. The first exacerbation event had median duration of 14 days(IQR 8-22); 23% of these were prolonged exacerbations. Severity of exacerbation was the only factor statistically significant at the p Prolonged duration occurs in nearly one quarter of exacerbations. Severity of exacerbation likely influences the outcome rather than explain it. However, prolonged duration may be influenced by season and fat free mass index. These factors should be taken into consideration and suggest that closer post-discharge monitoring of patients who experience severe AECOPD may be warranted.