Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Risk Factors for Recurrent Exacerbations in the General Practitioners Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort

Nebal S. Abu Hussein
,
Stephanie Giezendanner
,
Pascal Urwyler
,
Pierre-olivier Bridevaux
ORCID logo ,
Prashant N. Chhajed
,
Thomas Geiser
,
Ladina Joos Zellweger
,
Melcolm Kohler
,
David Miedinger
,
Zahra Pasha
,
Robert Thurnheer
,
Christophe Von Garnier
,
Joerg D. Leuppi
* ORCID logo
Version 1 : Received: 2 October 2023 / Approved: 3 October 2023 / Online: 4 October 2023 (11:36:13 CEST)

A peer-reviewed article of this Preprint also exists.

Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med. 2023, 12, 6695. Abu Hussein, N.S.; Giezendanner, S.; Urwyler, P.; Bridevaux, P.-O.; Chhajed, P.N.; Geiser, T.; Joos Zellweger, L.; Kohler, M.; Miedinger, D.; Pasha, Z.; Thurnheer, R.; von Garnier, C.; Leuppi, J.D. Risk Factors for Recurrent Exacerbations in the General-Practitioner-Based Swiss Chronic Obstructive Pulmonary Disease (COPD) Cohort. J. Clin. Med. 2023, 12, 6695.

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

Keywords

COPD; Exacerbation; Primary health care; Risk factors; Prediction; recurrent exacerbations

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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