Changes in Control Status of COPD Over Time and Their Consequences: A Prospective International Study |
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| Institution: | 1. Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain;2. CIBER de Enfermedades Respiratorias (CIBERES), Spain;3. 2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland;4. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;5. Department of Respiratory Medicine, Royal College of Surgeons, Dublin, Ireland;6. Optimum Patient Care, Cambridge, UK;7. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore;8. Duke-National University of Singapore Medical School, Singapore;9. Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark;10. Respiratory Department, Hospital de Alta Resolución de Loja, Spain;11. Department of Respiratory Medicine, Mater Dei Hospital, Malta;12. Public Health, Mental, Maternal and Child Health Nursing Department, Faculty of Medicine and Health Sciences, University of Barcelona, Spain;13. Department of Respiratory Medicine, Hospital Comarcal de Laredo, Cantabria, Spain;14. Respiratory and Critical Care Medicine, Changi General Hospital, Singapore;15. Primary Health-care Center Son Pisà, IB-Salut, Palma, Baleares, Spain;p. Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain;q. Centre of Academic Primary Care, University of Aberdeen, UK;r. Observational and Pragmatic Research Institute, Singapore;11. Hospital Universitari Vall d’Hebron, Barcelona, Spain;12. Hospital de Alta Resolución de Loja, Spain;13. Hospital Comarcal de Laredo, Cantabria, Spain;14. Primary Health-care Center Son Pisà, IB-Salut, Palma de Mallorca, Spain;15. Institute of Tuberculosis and Lung Diseases, Warsaw, Poland;16. St Mary''s Hospital, Seoul, Korea;17. Singapore General Hospital, Singapore;18. Changi General Hospital, Singapore;19. Optimum Patient Care, Cambridge, UK;110. Mater Dei Hospital, Malta;111. Royal College of Surgeons, Dublin, Ireland |
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| Abstract: | IntroductionControl status may be a useful tool to assess response to treatment at each clinical visit in COPD. Control status has demonstrated to have long-term predictive value for exacerbations, but there is no information about the short-term predictive value of the lack of control and changes in control status over time.MethodProspective, international, multicenter study aimed at describing the short-term (6 months) prognostic value of control status in patients with COPD. Patients with COPD were classified as controlled/uncontrolled at baseline and at 3,6-month follow-up visits using previously validated criteria of control. Moderate and severe exacerbation rates were compared between controlled and uncontrolled visits and between patients persistently controlled, uncontrolled and those changing control status over follow-up.ResultsA total of 267 patients were analyzed: 80 (29.8%) were persistently controlled, 43 (16%) persistently uncontrolled and 144 (53.7%) changed control status during follow-up. Persistently controlled patients were more frequently men, with lower (not increased) body mass index and higher FEV1(%). During the 6 months following an uncontrolled patient visit the odds ratio (OR) for presenting a moderate exacerbation was 3.41 (95% confidence interval (CI) 2.47–4.69) and OR = 4.25 (95%CI 2.48–7.27) for hospitalization compared with a controlled patient visit.ConclusionsEvaluation of control status at each clinical visit provides relevant prognostic information about the risk of exacerbation in the next 6 months. Lack of control is a warning signal that should prompt investigation and action in order to achieve control status. |
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| Keywords: | COPD Control CAT Exacerbations Outcomes EPOC Control TAC Exacerbaciones Resultados |
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