COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD
Qinglin Chen,1,* Xinmao Wang,1,* Xiujuan Yao,1 Luo Zhang,2– 4 Xiaofang Liu1 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Laboratory of Allergic Diseases, Beijing Muni...
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Dove Medical Press
2025-06-01
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| Series: | International Journal of COPD |
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| author | Chen Q Wang X Yao X Zhang L Liu X |
| author_facet | Chen Q Wang X Yao X Zhang L Liu X |
| author_sort | Chen Q |
| collection | DOAJ |
| description | Qinglin Chen,1,* Xinmao Wang,1,* Xiujuan Yao,1 Luo Zhang,2– 4 Xiaofang Liu1 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission, Beijing, People’s Republic of China; 3Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education of China, Beijing Institute of Otolaryngology, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaofang Liu, Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No.2, Xinanhuan Road, Yizhuang District, Beijing, 100176, China, Email xfliutrhos@163.com Luo Zhang, Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education of China, Beijing Institute of Otolaryngology, No. 17, Hougou Hutong, Chongnei, Dongcheng District, Beijing, 100730, China, Email dr.luozhang@139.comPurpose: The aim of this study was to explore the predictive value of the chronic obstructive pulmonary disease (COPD) specific comorbidity test index (COTE) and pulmonary comorbidities for moderate-to-severe acute exacerbation and hospitalization in COPD patients.Patients and Methods: This was a retrospective cohort study. We included 470 patients with stable COPD. Patients were divided into high or low-risk comorbidity group according to whether COTE score ≥ 4, and pulmonary comorbidities and extrapulmonary comorbidities group according to comorbidity origin. Moderate-to-severe acute exacerbation events and other clinical parameters were compared between groups. Multifactorial analysis and Lasso regression were used to screen risk factors and establish predictive models for moderate-to-severe acute exacerbation and hospitalization. The receiver operating characteristic (ROC) curve was used to assess the value COTE score and pulmonary comorbidities in predicting moderate-to-severe acute exacerbation and hospitalization.Results: When compared with the low-risk comorbidity and extrapulmonary comorbidities group, the rate of patients with ≥ 2 moderate-to-severe acute exacerbations and requiring hospitalization due to acute exacerbations is higher in high-risk comorbidity and pulmonary comorbidities group (χ²=18.45, χ²=40.15, χ²=8.82, χ²=23.68). Multifactorial analysis showed that comorbid with asthma, lung cancer were risk factors for moderate-to-severe acute exacerbations, while asthma, bronchiectasis, lung cancer, and high COTE score were risk factors for patients requiring hospitalization due to acute exacerbations. The AUC for COTE > 5.5 and a combination of at least one pulmonary comorbidity as potential indication of moderate-to-severe acute exacerbations of COPD and hospitalization due to acute exacerbations was 0.667 (95% CI: 0.615, 0.719) and 0.740 (95% CI: 0.688, 0.792), respectively. The prediction models including COTE and pulmonary comorbidities can predict moderate-to-severe acute exacerbations (internal validation of AUC: 0.984, 95CI%: 0.964– 1) and hospitalization (internal validation of AUC: 0.978, 95CI%: 0.959– 0.998) of COPD.Conclusion: COTE score and a combination of at least one pulmonary disease can predict the risk of moderate-to-severe acute exacerbations and hospitalization due to acute exacerbations in patients with COPD.Keywords: acute exacerbation, chronic obstructive, comorbidity, hospitalization, pulmonary disease |
| format | Article |
| id | doaj-art-afd334df6e474fad9add984065c3b7f5 |
| institution | Kabale University |
| issn | 1178-2005 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj-art-afd334df6e474fad9add984065c3b7f52025-08-20T03:26:57ZengDove Medical PressInternational Journal of COPD1178-20052025-06-01Volume 20Issue 118931913103806COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPDChen Q0Wang X1Yao X2Zhang L3Liu X4Department of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Otolaryngology Head and Neck SurgeryDepartment of Respiratory and Critical Care MedicineQinglin Chen,1,* Xinmao Wang,1,* Xiujuan Yao,1 Luo Zhang,2– 4 Xiaofang Liu1 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission, Beijing, People’s Republic of China; 3Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education of China, Beijing Institute of Otolaryngology, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaofang Liu, Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No.2, Xinanhuan Road, Yizhuang District, Beijing, 100176, China, Email xfliutrhos@163.com Luo Zhang, Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education of China, Beijing Institute of Otolaryngology, No. 17, Hougou Hutong, Chongnei, Dongcheng District, Beijing, 100730, China, Email dr.luozhang@139.comPurpose: The aim of this study was to explore the predictive value of the chronic obstructive pulmonary disease (COPD) specific comorbidity test index (COTE) and pulmonary comorbidities for moderate-to-severe acute exacerbation and hospitalization in COPD patients.Patients and Methods: This was a retrospective cohort study. We included 470 patients with stable COPD. Patients were divided into high or low-risk comorbidity group according to whether COTE score ≥ 4, and pulmonary comorbidities and extrapulmonary comorbidities group according to comorbidity origin. Moderate-to-severe acute exacerbation events and other clinical parameters were compared between groups. Multifactorial analysis and Lasso regression were used to screen risk factors and establish predictive models for moderate-to-severe acute exacerbation and hospitalization. The receiver operating characteristic (ROC) curve was used to assess the value COTE score and pulmonary comorbidities in predicting moderate-to-severe acute exacerbation and hospitalization.Results: When compared with the low-risk comorbidity and extrapulmonary comorbidities group, the rate of patients with ≥ 2 moderate-to-severe acute exacerbations and requiring hospitalization due to acute exacerbations is higher in high-risk comorbidity and pulmonary comorbidities group (χ²=18.45, χ²=40.15, χ²=8.82, χ²=23.68). Multifactorial analysis showed that comorbid with asthma, lung cancer were risk factors for moderate-to-severe acute exacerbations, while asthma, bronchiectasis, lung cancer, and high COTE score were risk factors for patients requiring hospitalization due to acute exacerbations. The AUC for COTE > 5.5 and a combination of at least one pulmonary comorbidity as potential indication of moderate-to-severe acute exacerbations of COPD and hospitalization due to acute exacerbations was 0.667 (95% CI: 0.615, 0.719) and 0.740 (95% CI: 0.688, 0.792), respectively. The prediction models including COTE and pulmonary comorbidities can predict moderate-to-severe acute exacerbations (internal validation of AUC: 0.984, 95CI%: 0.964– 1) and hospitalization (internal validation of AUC: 0.978, 95CI%: 0.959– 0.998) of COPD.Conclusion: COTE score and a combination of at least one pulmonary disease can predict the risk of moderate-to-severe acute exacerbations and hospitalization due to acute exacerbations in patients with COPD.Keywords: acute exacerbation, chronic obstructive, comorbidity, hospitalization, pulmonary diseasehttps://www.dovepress.com/cote-and-pulmonary-comorbidities-predict-moderate-to-severe-acute-exac-peer-reviewed-fulltext-article-COPDAcute exacerbationchronic obstructivecomorbidityhospitalizationpulmonary disease |
| spellingShingle | Chen Q Wang X Yao X Zhang L Liu X COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD International Journal of COPD Acute exacerbation chronic obstructive comorbidity hospitalization pulmonary disease |
| title | COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD |
| title_full | COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD |
| title_fullStr | COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD |
| title_full_unstemmed | COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD |
| title_short | COTE and Pulmonary Comorbidities Predict Moderate-to-Severe Acute Exacerbation and Hospitalization in COPD |
| title_sort | cote and pulmonary comorbidities predict moderate to severe acute exacerbation and hospitalization in copd |
| topic | Acute exacerbation chronic obstructive comorbidity hospitalization pulmonary disease |
| url | https://www.dovepress.com/cote-and-pulmonary-comorbidities-predict-moderate-to-severe-acute-exac-peer-reviewed-fulltext-article-COPD |
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