PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) are prone to exacerbations that are an important determinant of health-related quality of life, morbidity and mortality. Exacerbations are characterised by acute worsening of symptoms, increased airway inflammation and physiological deterioration. There seems to be a general consensus that exacerbation frequency increases with disease severity. However, little is known about the exacerbation of mild COPD patients. The aim of this study was to find out the differences according to the development of exacerbation of mild COPD patients.
METHODS: We constructed COPD patient cohort retrospectively in 5 hospitals affiliated with Hallym University Medical School. Stable COPD patients who took the spirometry test at least one time in the year of 2006 were enrolled. We compared the clinical, spirometric data of mild COPD patients according to the development of exacerbation during the follow-up period. The definition of mild COPD was adopted by the GOLD guideline.
RESULTS: There were 118 mild COPD patients in our cohort. Total 20 (16.9%) patients experienced the exacerbation during follow-up. Mean duration of follow-up was 13.0 months. Unfortunately, 65 (55.1%) patients failed to be followed up. Patients with exacerbation (exacerbator) were older than the patients without exacerbation during follow-up (non-exacerbator). The percentage predicted FEV1 of the exacerbator and non-exacerbator were 87.75±8.41 and 95.42±2.28, respectively, which was statistically significant (p=0.039). The smoking amount, body mass index and the other laboratory data were not different between the groups.
CONCLUSION: Total 16.9 % of mild COPD patients experienced the exacerbation during follow-up. Older patients with relatively lower FEV1 value were more likely to experience the exacerbation.
CLINICAL IMPLICATIONS: Even in mild COPD, there were some differences present according to the experience of exacerbation. A larger and prospective study will be warranted to clarify the differences.
DISCLOSURE: Ki-Suck Jung, No Financial Disclosure Information; No Product/Research Disclosure Information