Abstract
Background Recently, the Rome classification was proposed in which objective and readily measurable variables were integrated to mark exacerbations of COPD (ECOPD) severity. The aim of this study is to investigate the distribution of a real-world patient population with hospitalized ECOPD according to the current classification across the newly proposed severity classification. We assume that a significant proportion of hospitalized patients will have a mild or moderate event.
Methods The Rome classification was applied to a cohort of 364 COPD patients hospitalized at the Department of Respiratory Medicine of Maastricht University Medical Center (MUMC) with a severe ECOPD. Differences in in-hospital, 30- and 90-days mortality were compared between mild, moderate and severe ECOPD according to the new classification. Moreover, data was stratified by the different severity classes and compared regarding general disease characteristics and clinical parameters.
Results According to the Rome proposal, 52 (14.3%) patients had a mild ECOPD, 204 (56.0%) moderate and 108 (29.7%) patients a severe ECOPD. In-hospital mortality in mild, moderate and severe events was 3.8%, 6.9% and 13.9%, respectively. Most clinical parameters indicated a significantly worse condition in patients classified in the severe group, compared to those in mild or moderate groups.
Conclusion Most of the events, traditionally all classified as severe because of the hospitalization, were classified as moderate, while almost 15% were mild. The results of this study provide insight in the heterogeneity of hospitalized ECOPD and show that the newly proposed Rome criteria can differentiate between events with different short-term mortality rates.
Footnotes
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Conflict of interest: Adrian Endres has received grants from Frankfurter Arbeitskreis Pneumologie und Allergologie, Mukoviszidose e.V., and European Cystic Fibrosis Society, outside the submitted work; support for attending conference received from Insmed, outside the submitted work.
Conflict of interest: Dr S O Simons has received grants or contracts from AstraZeneca, GlaxoSmithKline, and Boehringer Ingelheim, outside the submitted work; consulting fees from GlaxoSmithKline, outside the submitted work; honoraria received from AstraZeneca and Chiesi for lectures outside the submitted work; support for attending meetings from Chiesi, outside the submitted work; honoraria for advisory board for Chiesi, and Boehringer Ingelheim, outside the submitted work.
Conflict of interest: Paul Savelkoul received a grant from Eurostar, outside the submitted work.
Conflict of interest: Frits ME Franssen received grants or contracts from AstraZeneca, outside the submitted work; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Chiesi, and Novartis, outside the submitted work; Support for attending meetings and/or travel from Chiesi, outside the submitted work.
Conflict of interest: The remaining authors have nothing to disclose.
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- Received October 27, 2022.
- Accepted January 27, 2023.
- Copyright ©The authors 2023
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