Work

Exacerbation history as a predictor of future exacerbations and mortality in COPD patients: A real-world study from a Portuguese integrated care health unit 2013–2018

Year: 2026

Type: article

Abstract: BACKGROUND: This study estimated the risk of exacerbations, cardiovascular (CV) death and all-cause death in COPD patients, according to their exacerbation profile. METHODS: A real-world, retrospective study, based on electronic health records from the Unidade Local de Saúde de Matosinhos, was conducted. Individuals ≥40 years, diagnosed with COPD between 2013 and 2018 and with 1 year of history prior to diagnosis were followed for 1 year. Patients were divided based on their exacerbation history: Cohort A: no exacerbations; Cohort B: one moderate exacerbation; Cohort C: ≥2 moderate exacerbations; Cohort D: one severe exacerbation; Cohort E: ≥2 exacerbations, with ≥1 severe. The 1-year risk of exacerbations, CV death and all-cause death were estimated based on Cox proportional hazard models (reference Cohort A). RESULTS: In total, 5696 COPD cases were identified, with median age increasing from Cohort A to E (68 to 74 years). The risk of moderate exacerbations was higher in Cohorts C (hazard ratio, HR = 1.95; 95% CI 1.70-2.25) and D (HR = 1.69; 95% CI 1.51-1.90). For severe exacerbations, cohorts D (HR = 2.95; 95% CI 2.51-3.46) and E (HR = 3.12; 95% CI 2.59-3.77) showed an increased risk. Cohort E also had the highest risk of CV death (HR = 1.65; 95% CI 1.17-2.34). Cohort D had the highest risk of all-cause death (HR = 1.65; 95% CI 1.24-2.18). DISCUSSION: A higher number and severity of prior exacerbations in patients with COPD increase their risk of future exacerbations, all-cause and CV death. These findings highlight the importance of implementing effective strategies to prevent exacerbations and improve disease management.

Source: Pulmonology

DOI: 10.1080/25310429.2026.2629617