Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations
Background: In chronic obstructive pulmonary disease (COPD), multiple recurrent severe exacerbations that require hospitalization can occur. These events are strongly associated with death and other clinical complications. Objectives: We aimed to develop a prognostic model that could identify patien...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-02-01
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| Series: | Therapeutic Advances in Chronic Disease |
| Online Access: | https://doi.org/10.1177/20406223231155115 |
| _version_ | 1811162956044435456 |
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| author | Elisa Valera-Novella Roberto Bernabeu-Mora Joaquina Montilla-Herrador Pilar Escolar-Reina José Antonio García-Vidal Francesc Medina-Mirapeix |
| author_facet | Elisa Valera-Novella Roberto Bernabeu-Mora Joaquina Montilla-Herrador Pilar Escolar-Reina José Antonio García-Vidal Francesc Medina-Mirapeix |
| author_sort | Elisa Valera-Novella |
| collection | DOAJ |
| description | Background: In chronic obstructive pulmonary disease (COPD), multiple recurrent severe exacerbations that require hospitalization can occur. These events are strongly associated with death and other clinical complications. Objectives: We aimed to develop a prognostic model that could identify patients with COPD that are at risk of multiple recurrent severe exacerbations within 3 years. Design: Prospective cohort. Methods: The derivation cohort comprised patients with stable, moderate-to-severe COPD. Multivariable logistic regression analyses were performed to develop the final model. Based on regression coefficients, a simplified index (ESEx) was established. Both, model and index, were assessed for predictive performance by measuring discrimination and calibration. Results: Over 3 years, 16.4% of patients with COPD experienced at least three severe recurrent exacerbations. The prognostic model showed good discrimination of high-risk patients, based on three characteristics: the number of severe exacerbations in the previous year, performance in the five-repetition sit-to-stand test, and in the 6-minute-walk test. The ESEx index provided good level of discrimination [areas under the receiver operating characteristic curve (AUCs): 0.913]. Conclusions: The ESEx index showed good internal validation for the identification of patients at risk of three recurrent severe COPD exacerbations within 3 years. These tools could be used to identify patients who require early interventions and motivate patients to improve physical performance to prevent recurrent exacerbations. |
| first_indexed | 2024-04-10T06:37:56Z |
| format | Article |
| id | doaj.art-e1f4a7638ada40e1965aa4e9908ebd40 |
| institution | Directory Open Access Journal |
| issn | 2040-6231 |
| language | English |
| last_indexed | 2024-04-10T06:37:56Z |
| publishDate | 2023-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Chronic Disease |
| spelling | doaj.art-e1f4a7638ada40e1965aa4e9908ebd402023-02-28T16:33:48ZengSAGE PublishingTherapeutic Advances in Chronic Disease2040-62312023-02-011410.1177/20406223231155115Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbationsElisa Valera-NovellaRoberto Bernabeu-MoraJoaquina Montilla-HerradorPilar Escolar-ReinaJosé Antonio García-VidalFrancesc Medina-MirapeixBackground: In chronic obstructive pulmonary disease (COPD), multiple recurrent severe exacerbations that require hospitalization can occur. These events are strongly associated with death and other clinical complications. Objectives: We aimed to develop a prognostic model that could identify patients with COPD that are at risk of multiple recurrent severe exacerbations within 3 years. Design: Prospective cohort. Methods: The derivation cohort comprised patients with stable, moderate-to-severe COPD. Multivariable logistic regression analyses were performed to develop the final model. Based on regression coefficients, a simplified index (ESEx) was established. Both, model and index, were assessed for predictive performance by measuring discrimination and calibration. Results: Over 3 years, 16.4% of patients with COPD experienced at least three severe recurrent exacerbations. The prognostic model showed good discrimination of high-risk patients, based on three characteristics: the number of severe exacerbations in the previous year, performance in the five-repetition sit-to-stand test, and in the 6-minute-walk test. The ESEx index provided good level of discrimination [areas under the receiver operating characteristic curve (AUCs): 0.913]. Conclusions: The ESEx index showed good internal validation for the identification of patients at risk of three recurrent severe COPD exacerbations within 3 years. These tools could be used to identify patients who require early interventions and motivate patients to improve physical performance to prevent recurrent exacerbations.https://doi.org/10.1177/20406223231155115 |
| spellingShingle | Elisa Valera-Novella Roberto Bernabeu-Mora Joaquina Montilla-Herrador Pilar Escolar-Reina José Antonio García-Vidal Francesc Medina-Mirapeix Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations Therapeutic Advances in Chronic Disease |
| title | Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations |
| title_full | Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations |
| title_fullStr | Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations |
| title_full_unstemmed | Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations |
| title_short | Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations |
| title_sort | development of the esex index a tool for predicting risk of recurrent severe copd exacerbations |
| url | https://doi.org/10.1177/20406223231155115 |
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