Pneumology Department, Hospital Universitari Vall d'Hebron; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain.
2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
Arch Bronconeumol (Engl Ed). 2021 Feb;57(2):122-129. doi: 10.1016/j.arbres.2020.06.003. Epub 2020 Jul 21.
Control status may be a useful tool to assess response to treatment at each clinical visit in COPD. Control status has demonstrated to have long-term predictive value for exacerbations, but there is no information about the short-term predictive value of the lack of control and changes in control status over time.
Prospective, international, multicenter study aimed at describing the short-term (6 months) prognostic value of control status in patients with COPD. Patients with COPD were classified as controlled/uncontrolled at baseline and at 3,6-month follow-up visits using previously validated criteria of control. Moderate and severe exacerbation rates were compared between controlled and uncontrolled visits and between patients persistently controlled, uncontrolled and those changing control status over follow-up.
A total of 267 patients were analyzed: 80 (29.8%) were persistently controlled, 43 (16%) persistently uncontrolled and 144 (53.7%) changed control status during follow-up. Persistently controlled patients were more frequently men, with lower (not increased) body mass index and higher FEV(%). During the 6 months following an uncontrolled patient visit the odds ratio (OR) for presenting a moderate exacerbation was 3.41 (95% confidence interval (CI) 2.47-4.69) and OR=4.25 (95%CI 2.48-7.27) for hospitalization compared with a controlled patient visit.
Evaluation of control status at each clinical visit provides relevant prognostic information about the risk of exacerbation in the next 6 months. Lack of control is a warning signal that should prompt investigation and action in order to achieve control status.
控制状况可能是一种有用的工具，可以在 COPD 的每次临床就诊时评估治疗反应。控制状况已被证明对加重具有长期预测价值，但缺乏控制和控制状况随时间变化的短期预测价值尚无信息。
这是一项前瞻性、国际性、多中心研究，旨在描述 COPD 患者控制状况的短期（6 个月）预后价值。使用先前验证的控制标准，在基线和 3、6 个月随访时将 COPD 患者分类为控制/未控制。比较控制和未控制就诊以及随访期间持续控制、未控制和控制状况改变的患者中中度和重度加重的发生率。
共分析了 267 例患者：80 例（29.8%）持续控制，43 例（16%）持续未控制，144 例（53.7%）在随访期间控制状况发生变化。持续控制的患者更多为男性，体重指数（BMI）较低（未增加），FEV%较高。在未控制患者就诊后的 6 个月内，中度加重的比值比（OR）为 3.41（95%置信区间（CI）为 2.47-4.69），与控制患者就诊相比，住院的 OR=4.25（95%CI 为 2.48-7.27）。
在每次临床就诊时评估控制状况可提供关于未来 6 个月内加重风险的相关预后信息。缺乏控制是一个警告信号，应促使进行调查和采取行动以实现控制状态。
