Prediction of acute respiratory disease in current and former smokers with and without COPD

Russell P. Bowler, Victor Kim, Elizabeth Regan, André A.A. Williams, Stephanie A. Santorico, Barry J. Make, David A. Lynch, John E. Hokanson, George R. Washko, Peter Bercz, Xavier Soler, Nathaniel Marchetti, Gerard J. Criner, Joe Ramsdell, Mei Lan K. Han, Dawn Demeo, Antonio Anzueto, Alejandro Comellas, James D. Crapo, Mark DransfieldJ. Michael Wells, Craig P. Hersh, Neil MacIntyre, Fernando Martinez, Hrudaya P. Nath, Dennis Niewoehner, Frank Sciurba, Amir Sharafkhaneh, Edwin K. Silverman, Edwin J.R. Van Beek, Carla Wilson, Christine Wendt, Robert A. Wise, Jeffrey Curtis, Ella Kazerooni, Nicola Hanania, Philip Alapat, Venkata Bandi, Kalpalatha Guntupalli, Elizabeth Guy, William Lunn, Antara Mallampalli, Charles Trinh, Mustafa Atik, Francine Jacobson, R. Graham Barr, Byron Thomashow, John Austin, Lacey Washington, H. Page McAdams, Richard Rosiello, Timothy Bresnahan, Charlene McEvoy, Joseph Tashjian, Nadia Hansel, Robert Brown, Richard Casaburi, Janos Porszasz, Hans Fischer, Matt Budoff, Tadashi Allen, Kathryn Rice, Marilyn Foreman, Gloria Westney, Eugene Berkowitz, Adam Friedlander, Eleonora Meoni, Aditi Satti, A. James Mamary, Robert Steiner, Chandra Dass, William Bailey, Lynn Gerald, Paul Ferguson, Paul Friedman, Geoffrey McLennan, Edwin J.R. Van Beek, Deborah Thompson, Joel Weissfeld, Carl Fuhrman, Jessica Bon, Sandra Adams, Carlos Orozco, C. Santiago Restrepo, Amy Mumbower, Jonathan Samet, Amy Willis, Douglas Stinson, Terri Beaty, Barbara Klanderman, Nan Laird, Christoph Lange, Iuliana Ionita, Joyce Schroeder, John Newell, John Reilly, Harvey Coxson, Philip Judy, Eric Hoff Man, Raul San Jose Estepar, Rebecca Leek, Jordan Zach, Alex Kluiber, Anastasia Rodionova, Tanya Mann, Robert Crapo, Robert Jensen, Homayoon Farzadegan, James Murphy, Douglas Everett

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The risk factors for acute episodes of respiratory disease in current and former smokers who do not have COPD are unknown.

METHODS: Eight thousand two hundred forty-six non-Hispanic white and black current and former smokers in the Genetic Epidemiology of COPD (COPDGene) cohort had longitudinal follow-up (LFU) every 6 months to determine acute respiratory episodes requiring antibiotics or systemic corticosteroids, an ED visit, or hospitalization. Negative binomial regression was used to determine the factors associated with acute respiratory episodes. A Cox proportional hazards model was used to determine adjusted hazard ratios (HRs) for time to first episode and an acute episode of respiratory disease risk score.

RESULTS: At enrollment, 4,442 subjects did not have COPD, 658 had mild COPD, and 3,146 had moderate or worse COPD. Nine thousand three hundred three acute episodes of respiratory disease and 2,707 hospitalizations were reported in LFU (3,044 acute episodes of respiratory disease and 827 hospitalizations in those without COPD). Major predictors included acute episodes of respiratory disease in year prior to enrollment (HR, 1.20; 95% CI, 1.15-1.24 per exacerbation), airflow obstruction (HR, 0.94; 95% CI, 0.91-0.96 per 10% change in % predicted FEV 1 ), and poor health-related quality of life (HR, 1.07; 95% CI, 1.06-1.08 for each 4-unit increase in St. George's Respiratory Questionnaire score). Risks were similar for those with and without COPD.

CONCLUSIONS: Although acute episode of respiratory disease rates are higher in subjects with COPD, risk factors are similar, and at a population level, there are more episodes in smokers without COPD.

Original languageEnglish (US)
Pages (from-to)941-950
Number of pages10
JournalCHEST
Volume146
Issue number4
DOIs
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Bowler, R. P., Kim, V., Regan, E., Williams, A. A. A., Santorico, S. A., Make, B. J., Lynch, D. A., Hokanson, J. E., Washko, G. R., Bercz, P., Soler, X., Marchetti, N., Criner, G. J., Ramsdell, J., Han, M. L. K., Demeo, D., Anzueto, A., Comellas, A., Crapo, J. D., ... Everett, D. (2014). Prediction of acute respiratory disease in current and former smokers with and without COPD. CHEST, 146(4), 941-950. https://doi.org/10.1378/chest.13-2946