The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study
Abstract Background Asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience exacerbations more frequently than those with asthma or COPD alone. Since low diffusing capacity of the lung for carbon monoxide (DLCO) is known as a strong risk factor for severe exacerbation i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-021-01815-w |
| _version_ | 1819007149584416768 |
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| author | Hiroaki Ogata Katsuyuki Katahira Aimi Enokizu-Ogawa Yujiro Jingushi Akiko Ishimatsu Kazuhito Taguchi Hiroko Nogami Hiroshi Aso Atsushi Moriwaki Makoto Yoshida |
| author_facet | Hiroaki Ogata Katsuyuki Katahira Aimi Enokizu-Ogawa Yujiro Jingushi Akiko Ishimatsu Kazuhito Taguchi Hiroko Nogami Hiroshi Aso Atsushi Moriwaki Makoto Yoshida |
| author_sort | Hiroaki Ogata |
| collection | DOAJ |
| description | Abstract Background Asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience exacerbations more frequently than those with asthma or COPD alone. Since low diffusing capacity of the lung for carbon monoxide (DLCO) is known as a strong risk factor for severe exacerbation in COPD, DLCO or a transfer coefficient of the lung for carbon monoxide (KCO) is speculated to also be associated with the risk of exacerbations in ACO. Methods This study was conducted as an observational cohort survey at the National Hospital Organization Fukuoka National Hospital. DLCO and KCO were measured in 94 patients aged ≥ 40 years with a confirmed diagnosis of ACO. Multivariable-adjusted hazard ratios (HRs) for the exacerbation-free rate over one year were estimated and compared across the levels of DLCO and KCO. Results Within one year, 33.3% of the cohort experienced exacerbations. After adjustment for potential confounders, low KCO (< 80% per predicted) was positively associated with the incidence of exacerbation (multivariable-adjusted HR = 3.71 (95% confidence interval 1.32–10.4)). The association between low DLCO (< 80% per predicted) and exacerbations showed similar trends, although it failed to reach statistical significance (multivariable-adjusted HR = 1.31 (95% confidence interval 0.55–3.11)). Conclusions Low KCO was a significant risk factor for exacerbations among patients with ACO. Clinicians should be aware that ACO patients with impaired KCO are at increased risk of exacerbations and that careful management in such a population is mandatory. |
| first_indexed | 2024-12-21T00:19:59Z |
| format | Article |
| id | doaj.art-18abd8c9c04445e092107de67602e9af |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-21T00:19:59Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-18abd8c9c04445e092107de67602e9af2022-12-21T19:22:07ZengBMCBMC Pulmonary Medicine1471-24662022-01-0122111010.1186/s12890-021-01815-wThe association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort studyHiroaki Ogata0Katsuyuki Katahira1Aimi Enokizu-Ogawa2Yujiro Jingushi3Akiko Ishimatsu4Kazuhito Taguchi5Hiroko Nogami6Hiroshi Aso7Atsushi Moriwaki8Makoto Yoshida9Department of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalDepartment of Respiratory Medicine, National Hospital Organization Fukuoka National HospitalAbstract Background Asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience exacerbations more frequently than those with asthma or COPD alone. Since low diffusing capacity of the lung for carbon monoxide (DLCO) is known as a strong risk factor for severe exacerbation in COPD, DLCO or a transfer coefficient of the lung for carbon monoxide (KCO) is speculated to also be associated with the risk of exacerbations in ACO. Methods This study was conducted as an observational cohort survey at the National Hospital Organization Fukuoka National Hospital. DLCO and KCO were measured in 94 patients aged ≥ 40 years with a confirmed diagnosis of ACO. Multivariable-adjusted hazard ratios (HRs) for the exacerbation-free rate over one year were estimated and compared across the levels of DLCO and KCO. Results Within one year, 33.3% of the cohort experienced exacerbations. After adjustment for potential confounders, low KCO (< 80% per predicted) was positively associated with the incidence of exacerbation (multivariable-adjusted HR = 3.71 (95% confidence interval 1.32–10.4)). The association between low DLCO (< 80% per predicted) and exacerbations showed similar trends, although it failed to reach statistical significance (multivariable-adjusted HR = 1.31 (95% confidence interval 0.55–3.11)). Conclusions Low KCO was a significant risk factor for exacerbations among patients with ACO. Clinicians should be aware that ACO patients with impaired KCO are at increased risk of exacerbations and that careful management in such a population is mandatory.https://doi.org/10.1186/s12890-021-01815-wAsthma-COPD overlapDiffusing capacity of the lungTransfer coefficient of the lungExacerbationForced expiratory volume in 1 s |
| spellingShingle | Hiroaki Ogata Katsuyuki Katahira Aimi Enokizu-Ogawa Yujiro Jingushi Akiko Ishimatsu Kazuhito Taguchi Hiroko Nogami Hiroshi Aso Atsushi Moriwaki Makoto Yoshida The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study BMC Pulmonary Medicine Asthma-COPD overlap Diffusing capacity of the lung Transfer coefficient of the lung Exacerbation Forced expiratory volume in 1 s |
| title | The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study |
| title_full | The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study |
| title_fullStr | The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study |
| title_full_unstemmed | The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study |
| title_short | The association between transfer coefficient of the lung and the risk of exacerbation in asthma-COPD overlap: an observational cohort study |
| title_sort | association between transfer coefficient of the lung and the risk of exacerbation in asthma copd overlap an observational cohort study |
| topic | Asthma-COPD overlap Diffusing capacity of the lung Transfer coefficient of the lung Exacerbation Forced expiratory volume in 1 s |
| url | https://doi.org/10.1186/s12890-021-01815-w |
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