RISK OF ACUTE EXACERBATION AND SEVERE ACUTE EXACERBATION ASSOCIATED WITH DIFFERENT SEVERITIES OF COPD AT DIAGNOSIS- A PROSPECTIVE COHORT STUDY IN KOREA
Author(s)
KIM S, CHO S
Seoul National University, Seoul, Korea, Republic of (South)
Presentation Documents
OBJECTIVES: Recent studies suggest decline of lung function in COPD occurs in the earlier course of disease than previously thought, which suggest need for implementation of aggressive testing to avoid delay in diagnosis and respective initiation of treatments. This study aimed to assess the difference in health outcomes, specifically acute exacerbation and severe acute exacerbation between the patients diagnosed at varying severities of COPD. METHODS: This prospective cohort study used the National Health Insurance Service-National Sample Cohort(NHIS-NSC) to enroll newly diagnosed COPD patients with varying disease severities of mild, moderate and severe COPD between 2006 and 2007, then the patients were followed up until the events of acute exacerbation and severe acute exacerbation or until 31st December 2013. RESULTS: Total of 1,280 patients (685 patients diagnosed as mild COPD, 383 patients diagnosed as moderate COPD, 212 patients diagnosed as severe COPD) was enrolled to the study. When compared to patients diagnosed as mild COPD, the risk of acute exacerbation was higher for patients diagnosed as moderate COPD (unadjusted HR: 1.13, 95% CI: 0.70-1.82; adjusted HR: 1.07, 95% CI: 0.72-1.59) and more dramatically with patients diagnosed as severe COPD (unadjusted HR: 2.45, 95% CI: 1.54-3.88; adjusted HR: 2.12, 95% CI: 1.43-3.14). The risk of severe acute exacerbation was also higher for patients diagnosed as moderate COPD (unadjusted HR: 1.45, 95% CI: 0.99-2.13; adjusted HR: 1.36, 95% CI: 0.94-1.96) and for the patients diagnosed as severe COPD (unadjusted HR: 2.94, 95% CI: 2.02-4.29; adjusted HR: 2.56, 95% CI: 1.77-3.71) as compared to mild COPD patients. CONCLUSIONS: The risk of acute exacerbation and severe acute exacerbation was increased in patients diagnosed as moderate COPD and more dramatically with patients diagnosed as severe COPD when compared to patients with mild COPD at diagnosis, which may contribute as an evidence to enhancing importance of early diagnosis in COPD.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRS10
Topic
Epidemiology & Public Health
Disease
Respiratory-Related Disorders