Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients

This retrospective observational study examined the relationship between several COPD comorbidities and frequency of COPD exacerbation at follow up. The comorbid conditions studied included hypertension, ischemic heart disease, congestive heart failure, cerebrovascular disease, cor pulmonale, diabetes mellitus, malignancy, asthma, tuberculosis-destroyed lung, chronic liver disease and chronic kidney disease. The authors distinguish this work from prior research in that it did not rely on the aggregate Charlson comorbidity index, but instead sought to gauge the influence of the individual disease states on future exacerbations.

Patients with comorbid asthma were four times more likely to have frequent exacerbations within one year of a previous exacerbation. Those with frequent exacerbations both at 30-day and one-year were more likely to 1) have lower FEV1 values, 2) be on home oxygen therapy and 2) take long-term oral steroids. Higher levels of the inflammatory biomarker CRP were also associated with increased subsequent exacerbations within one year.