Meng Weiwei, Wu Jiankang, Wang Jiayu, Zhao Rui, Liu Sisi, Xie Naishu, Huang Qixuan, Liu Lijun, Liang Yanchao, Zeng Huihui, Ma Yiming, Chen Yan
Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.
Int J Med Sci. 2025 Apr 13;22(9):2227-2236. doi: 10.7150/ijms.111294. eCollection 2025.
Treatable traits (TTs)" is a precision medicine strategy for the management of chronic airway diseases. However, data on TTs in hospitalized AECOPD patients are limited. This study aimed to determine the prevalence of TTs in Chinese patients hospitalized with AECOPD and which traits predict future exacerbation risk, and to develop an exacerbation prediction model. This multicenter, cohort study recruited patients hospitalized with AECOPD from January 2022 to April 2023. Participants underwent a multidimensional assessment to characterize the TTs and were then followed up for one year. Cox regression analyses were used to determine the association between TTs and future exacerbations and develop a prediction model. Finally, 28 TTs, including pulmonary (n=11), extra-pulmonary (n=12) and behavioral/risk factors (n=5) were identified. Five traits were associated with increased risk of future AECOPD readmission, including frequent exacerbations in the past year (adjusted HR: 2.079, 95% CI: 1.246-3.469), O desaturation (adjusted HR: 1.754, 95% CI: 1.001-3.075), eosinophilic airway inflammation (adjusted HR: 1.731, 95% CI: 1.078-2.777), pathogen colonization (adjusted HR: 1.852, 95% CI: 1.147-2.990) and gastroesophageal reflux (adjusted HR: 5.500, 95% CI: 1.923-15.730). Furthermore, one regression model was developed to predict personalized exacerbation risk and showed acceptable performance. TTs can be systematically assessed in Chinese patients hospitalized with AECOPD, some of which are associated with future exacerbation-related readmission.
“可治疗特征（TTs）”是一种用于管理慢性气道疾病的精准医学策略。然而，关于住院的慢性阻塞性肺疾病急性加重期（AECOPD）患者TTs的数据有限。本研究旨在确定中国住院AECOPD患者中TTs的患病率，以及哪些特征可预测未来加重风险，并开发一种加重预测模型。这项多中心队列研究招募了2022年1月至2023年4月因AECOPD住院的患者。参与者接受了多维度评估以表征TTs，然后随访一年。采用Cox回归分析来确定TTs与未来加重之间的关联并开发预测模型。最后，确定了28个TTs，包括肺部特征（n = 11）、肺外特征（n = 12）和行为/风险因素（n = 5）。五个特征与未来AECOPD再入院风险增加相关，包括过去一年频繁加重（调整后HR：2.079，95%CI：1.246 - 3.469）、氧饱和度下降（调整后HR：1.754，95%CI：1.001 - 3.075）、嗜酸性气道炎症（调整后HR：1.731，95%CI：1.078 - 2.777）、病原体定植（调整后HR：1.852，95%CI：1.147 - 2.990）和胃食管反流（调整后HR：5.500，95%CI：1.923 - 15.730）。此外，开发了一个回归模型来预测个性化加重风险，并显示出可接受的性能。在中国住院的AECOPD患者中，可以系统地评估TTs，其中一些与未来与加重相关的再入院有关。
