Cough and Sputum Production Are Associated With Frequent Exacerbations and Hospitalizations in COPD Subjects
Cough and Sputum Production Are Associated With Frequent Exacerbations and Hospitalizations in COPD Subjects
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DOI：
10.1378/chest.08-2062
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发表时间：
2009-04-01
期刊：
影响因子：
9.6
通讯作者：
Roche, Nicolas
中科院分区：
文献类型：
--
作者：
Burgel, Pierre-Regis;Nesme-Meyer, Pascale;Roche, Nicolas
背景资料：流行病学研究表明，慢性咳嗽和咳痰与COPD受试者的死亡率和疾病进展增加相关。我们的目的是确定与慢性咳嗽和痰的生产在COPD subjects.Methods：横断面分析的数据获得了一个多中心（17所大学医院在法国）队列的COPD患者的功能。该队列包括433例COPD受试者（65 ± 11岁; FEV 1 50 ± 20%预测值）。受试者（n = 321）和没有（n = 112）慢性咳嗽和痰production.Results：年龄，FEV 1体重指数，合并症组之间没有显着差异。慢性咳嗽和咳痰的受试者每年每例患者的急性加重总平均次数增加（分别为2.20 +/- 2.20 vs 0.97 +/- 1.19; p < 0.0001），中度加重（分别为1.80 +/- 2.07 vs 0.66 +/- 0.85; p < 0.0001）和需要住院治疗的严重急性发作。(0.43分别为+/- 0.95对0.22 +/- 0.56; p < 0.02）。每例患者每年急性加重的总次数是与慢性咳嗽和咳痰独立相关的唯一变量。在伴有和不伴有慢性咳嗽和咳痰的受试者中，分别有55%和22%的受试者发生频繁的急性加重（每例患者每年两次或两次以上）（p < 0.0001）。慢性咳嗽、咳痰和FEV 1降低与COPD频繁加重和频繁住院的风险增加独立相关。结论：慢性咳嗽和咳痰与COPD频繁加重相关，包括需要住院的严重加重。
Background: Epidemiologic studies indicate that chronic cough and sputum production are associated with increased mortality and disease progression in COPD subjects. Our objective was to identify features associated with chronic cough and sputum production in COPD subjects.Methods: Cross-sectional analysis of data were obtained in a multicenter (17 university hospitals in France) cohort of COPD patients. The cohort comprised 433 COPD subjects (65 +/- 11 years; FEV1 50 +/- 20% predicted). Subjects with (n = 321) and without (n = 112) chronic cough and sputum production were compared.Results: No significant difference was observed between groups for age, FEV1 body mass index, and comorbidities. Subjects with chronic cough and sputum production had increased total mean numbers of exacerbations per patient per year (2.20 +/- 2.20 vs 0.97 +/- 1.19, respectively; p < 0.0001), moderate exacerbations (1.80 +/- 2.07 vs 0.66 +/- 0.85, respectively; p < 0.0001), and severe exacerbations requiring hospitalizations. (0.43 +/- 0.95 vs 0.22 +/- 0.56, respectively; p < 0.02). The total number of exacerbations per patient per year was the only variable independently associated with chronic cough and sputum production. Frequent exacerbations (two or more per patient per year) occurred in 55% vs 22% of subjects, respectively, with and without chronic cough and sputum production (p < 0.0001). Chronic cough and sputum production and decreased FEV1 were independently associated with an increased risk of frequent exacerbations and frequent hospitalizations.Conclusions: Chronic cough and sputum production are associated with frequent COPD exacerbations, including severe exacerbations requiring hospitalizations.