Identifying the Phenotype of Frequent Acute Exacerbations in COPD Patients Based on Clinical & Imaging Characteristics

The following is a summary of “Identification of frequent acute exacerbations phenotype in COPD patients based on imaging and clinical characteristics,” published in the February 2023 issue of Pulmonology by Zhu, et al.

Acute exacerbations of chronic obstructive pulmonary disease (COPD), a frequent condition with significant morbidity, show up as an aggravation of respiratory symptoms. For a study, researchers sought to identify the COPD patient population with a frequent acute exacerbation phenotype based on imaging and clinical features.

To categorize COPD patients into frequent and non-frequent exacerbation groups based on the frequency and severity of acute exacerbations, COPD patients (n = 201) were tracked for acute exacerbations one year following their initial hospital admission. Low attenuation area of less than -950Hu (LAA-950) in the whole lung was measured on high-resolution CT images for all patients. Across groups, variations in LAA-950, clinical fundamental features, and visual subtypes were compared. Binary logistic regression was used to identify the clinical factors influencing frequent exacerbation. Ultimately, the receiver operating characteristic curve was used to define the COPD phenotype with frequent acute exacerbations based on imaging and clinical variables.

Participants who experienced frequent exacerbations had a higher LAA-950 than individuals who did not experience frequent exacerbations (P< 0.001). A deterioration of the visual subtypes was linked to frequent acute exacerbations. Age, smoking status, BMI, FEV1 pred, and LAA-950 were all linked to more frequent exacerbations of COPD, according to multivariate binary logistic regression. Based on factors such as age, smoking status, BMI, FEV1 pred, and LAA-950, the area under the receiver operating characteristic curve for predicting frequent exacerbations was 0.907 (P< 0.001).

In order to identify individuals with COPD who frequently experienced acute exacerbations, imaging data, and clinical traits were combined to achieve excellent diagnostic effectiveness.


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