Combined Assessment Tool to Identify High-risk Individuals to Predict Severe Exacerbations in a UK Multi-centre Chronic Obstructive Pulmonary Disease Cohort
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Le résumé fourni par la source
Abstract Background: Recognising the importance of patient-reported outcomes in assessing COPD severity, the GOLD ABE assessment tool highlights the clinical priority of exacerbations and in those with infrequent exacerbations, symptoms. It has the potential to identify high-risk individuals with COPD which may be important for disease progression and to guide treatments. However, the GOLD ABE tool has not been validated in clinical research studies. Aim: To evaluate the utility of GOLD ABE assessment to predict severe exacerbations in a UK COPD cohort. Firstly, to evaluate across A-B-E within the cohort and then compare the tool to other established COPD severity indices (GOLD grade and BODE quartiles). Methods:664 participants from the ERICA (Evaluation of the Role of Inflammation in Chronic Airways Disease) COPD cohort with complete data to enable classification based on GOLD ABE, GOLD grade (2-4) and BODE quartiles were selected. The COPD Assessment Test (CAT) score was used to assess symptoms for A-B and repeat analysis with mMRC was also undertaken. NHS hospital episode statistics (HES) data were prospectively collected for a median 4.75 years of follow-up and hospital admissions for acute exacerbations of COPD (severe exacerbations, H-AECOPD) were extracted from hospital episode primary position ICD-10 codes. Cox proportional hazards regression, logistic regression and ROC analyses were undertaken. Models were performed unadjusted and then adjusted for age and sex (and FEV1 for ABE). Data are presented as median (IQR), average±SD, n (%). Results: Out of 664 participants, GOLD ABE stratification was as follows: A=60 participants (9%), B=277 (42%), E=327 (49%), 324 (49%) were on triple inhaled therapy. A total of 225 participants (34%) in the cohort had H-AECOPD over follow up with median time to first H-AECOPD being 525 (205-1071) days. 46% of group E, 25% in group B and 10% in group A had a H-AECOPD over follow-up. Group B had a higher risk of H-AECOPD and time to first H-AECOPD compared with group A (p<0.01 for both), despite both groups being infrequent exacerbators at baseline. Table 1 shows further data for ABE, GOLD grade and BODE quartiles. Conclusion: ABE was not more strongly associated with H-AECOPD than other COPD severity indices. Its utility from these data, however, seems to be across the A-B-E comparison to identify individuals at higher risk for future H-AECOPD. Table 1
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Combined Assessment Tool to Identify High-risk Individuals to Predict Severe Exacerbations in a UK Multi-centre Chronic Obstructive Pulmonary Disease Cohort
- Date Crossref
- 01/05/2025
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Cambridge Cambridge Clinical Trials Unit pays non établi dans la noticeUniversité ou école supérieure
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Addenbrooke's Hospital pays non établi dans la noticeÉtablissement de santé
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Papworth Hospital NHS Foundation Trust Cardiology pays non établi dans la noticeÉtablissement de santé
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Cambridge University Hospitals NHS Foundation Trust Respiratory medicine pays non établi dans la noticeOrganisme public
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University of Nottingham Nottingham Respiratory Research Unit pays non établi dans la noticeUniversité ou école supérieure
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Cardiff Metropolitan University pays non établi dans la noticeUniversité ou école supérieure
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The Queen's Medical Research Institute pays non établi dans la noticeOrganisme public
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Royal Brompton Hospital Respiratory Medicine pays non établi dans la noticeÉtablissement de santé
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Cardiff School of Sport and Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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ELEGI Colt Lab/The Queen Med Rsch Inst pays non établi dans la noticeInstitution
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Global Allergies and Airways Patient Platform pays non établi dans la noticeInstitution
Cambridge Clinical Trials Unit — University of Cambridge, Addenbrooke's Hospital et Cardiology — Papworth Hospital NHS Foundation Trust, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.