Susceptibility to Exacerbation in Chronic Obstructive Pulmonary Disease

This study examined the rate of exacerbations among patients with COPD over a period of 3 years. The strongest predictor of an exacerbation in a given year was the presence of an exacerbation in the previous year. The natural history of chronic obstructive pulmonary disease (COPD) is punctuated by exacerbations — acute worsening of symptoms. Exacerbations appear to accelerate the decline in lung function that characterizes COPD, 1 , 2 resulting in reduced physical activity, 3 poorer quality of life, 4 and an increased risk of death, 5 and they are also responsible for a large proportion of the health care costs attributable to this prevalent condition. 6 Consequently, exacerbations are important outcomes in clinical trials, and their prevention is a key component of COPD-management strategies. 7 Despite the importance of exacerbations, we know relatively little about their incidence, their determinants, and their effects . . .