Modified MRC assessment and FEV1.0 can predict frequency of acute exacerbation of COPD

When the severity of the chronic obstructive pulmonary disease (COPD) worsens, the incidence of acute exacerbation (AE) rises, says an article published in Respiratory Medicine. 

A clinical diagnosis of an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is determined when a COPD patient exhibits a persistent increase in cough, sputum output, and/or dyspnea. AECOPD can have a variety of clinical effects, such as a self-limited condition or progressive respiratory failure. Poor outcomes are caused by acute exacerbations of chronic obstructive pulmonary disease, which can be lethal. Unfortunately, it is not widely recognized in Japan what the actual frequency and poor prognostic variables are. Because poor prognostic indicators are not widely recognized in Japan, Nobuhiro Asai and his team undertook this investigation to determine the exact incidence of each.

At the Kameda Medical Center in Japan, researchers conducted this prospective cohort study between 2011 and 2013 to evaluate the prevalence and risk factors of AE. The GOLD recommendation defined AE as an abrupt aggravation of respiratory symptoms. Also, the groups' exacerbation-free times were contrasted.

The key findings of this study were;

The trial recruited 330 participants in total. 

94% of the patients were men, and the study's average patient age was 73. 

All patients had an average of 0.17 AE events per patient per year. 

While COPD disease severity rose, AE frequency also increased. Patients with GOLD I had a longer exacerbation-free period than those with GOLD II, and those with GOLD II grade COPD had a longer exacerbation-free period than those with GOLD III grade COPD. 

The Modified Medical Research Council (mMRC) scale 3 and FEV1.0% 50% were independently bad prognosis indicators for moderate grade AE occurrences, while the mMRC scale 3 was independently poor prognostic for severe AE events, according to logistic regression analysis of risk factors for AE.

This study discovered that FEV1 50% and mMRC scale >3 were risk variables for AE-COPD.

Reference: 

Asai, N., Ohkuni, Y., Ohashi, W., & Kaneko, N. (2023). Modified MRC assessment and FEV1.0 can predict frequent acute exacerbation of COPD: An observational prospective cohort study at a single-center in Japan. In Respiratory Medicine (p. 107218). Elsevier BV. https://doi.org/10.1016/j.rmed.2023.107218