Frequent exacerbators among patients with COPD - prevalence and stability

Abstract

Topic: There is not enough data in Bulgaria about the prevalence and stability of the frequent exacerbator phenotype among COPD patients. Aim: To study the prevalence and stability of the frequent exacerbator phenotype among COPD patients. Methods: We followed up 465 COPD patients for exacerbations during a 3 year period. Exacerbations were defined as events treated with antibiotics and/or corticosteroids (moderate), or hospitalization (severe). Result: Approximately 10% of all COPD patients had two or more exacerbations per year (frequent exacerbators) and this rate stayed stable over the period. In the first year of follow up exacerbation rate was 0.33 per for stage 1 COPD patients (according to GOLD spirometry stages), 0.49 for stage 2; 0.69 for stage 3 and 1.06 for stage 4 patients. The frequent exacerbator rate also increased from stage 1 to stage 4 as follow: 4,35%, 9.17%, 10.79% and 20.97% respectively. A history for exacerbations in the previous year increased the risk of a new exacerbation: history for one exacerbation- OR 2.1820(95 % CI: 1.4018 to 3.3965, P = 0.0005), history for two exacerbations-OR 4.6460 (95 % CI: 2.3286 to 9.2696; P Conclusion: The exacerbation frequency and the rate of frequent exacerbators increases with COPD severity. History of exacerbations in the previous year is a significant risk factor for COPD exacerbations. The frequent-exacerbation phenotype did not appear to be stable over the period.