Husebe et al reported predictors for an acute exacerbation for a patient with chronic obstructive pulmonary disease (AECOPD). These can help to identify a patient who may benefit from more aggressive management. The authors are from Haukeland University Hospital, University of Bergen and University of Oslo.
Patient selection: chronic obstructive pulmonary disease (COPD)
Outcome: acute exacerbation (AECOPD)
Predictors of an acute exacerbation from multivariate analysis:
(1) female sex (RR 1.5)
(2) older age (RR 1.23 per 10-year increase, with youngest patient 44 years)
(3) 2 or more episodes of AECOPD in past year (RR 1.7)
(4) higher GOLD stage (GOLD III RR 1.4; GOLD IV RR 2.9)
(5) chronic cough (RR 1.6)
(6) use of inhaled steroids (RR 1.6)
where:
• Handling of age is a little unclear. One interpretation is absolute age. The second is the time since the youngest patient in study, which was 44. Since RR of 1 if for this end of the spectrum, the latter interpretation will be used in the implementation.
Predictors for duration of an exacerbation > 3 weeks:
(1) hypoxemia with PaO2 < 8 kPa (RR 0.6)
(2) years since inclusion (RR 1.2)
(3) AECOPD severity (moderate RR 1.6; severe RR 2.3)
(4) season (winter RR 1.5; spring RR 1.5)
(5) serum soluble tumor necrosis factor receptor 1 TNF-R1 (RR 1.16 per SD increase)
