|Title:||Wheezing, a significant clinical phenotype of COPD: Experience from the Taiwan Obstructive Lung Disease Study||Authors:||Huang W.-C.
|Issue Date:||2015||Publisher:||Dove Medical Press Ltd.||Journal Volume:||10||Journal Issue:||1||Start page/Pages:||2121-2126||Source:||International Journal of COPD||Abstract:||
Background: COPD is an important public health challenge with significant heterogeneity of clinical presentation and disease progression. Clinicians have been trying to find phenotypes that may be linked to distinct prognoses and different therapeutic choices. Not all patients with COPD present with wheezing, a possible clinical phenotype that can help differentiate patient subgroups. Methods: The Taiwan Obstructive Lung Disease study was a retrospective, multicenter research study to investigate the treatment patterns of COPD after the implementation of the Global Initiative for Chronic Obstructive Lung Disease 2011 guidelines. Between November 2012 and August 2013, medical records were retrieved from patients with COPD aged ?40 years; patients diagnosed with asthma were excluded. Demographic data, lung function, symptom scores, and acute exacerbation were recorded and analyzed, and the differences between patients with and without wheezing were evaluated. Results: Of the 1,096 patients with COPD, 424 (38.7%) had the wheezing phenotype. The wheezing group had significantly higher COPD Assessment Test scores (12.4±7.8 versus 10.5±6.7, P,0.001), higher modified Medical Research Council grade (2.0±1.0 versus 1.7±0.9, P<0.001), and more acute exacerbations within the past year (0.9±1.3 versus 0.4±0.9, P<0.001) than the nonwheezing group. The postbronchodilator forced expiratory volume in 1 second was lower in wheezing patients (1.2±0.5 L versus 1.5±0.6 L, P<0.001). Even in patients with maintenance treatment fitting the Global Initiative for Chronic Obstructive Lung Disease 2011 guidelines, the wheezing group still had worse symptom scores and more exacerbations. Conclusion: Wheezing is an important phenotype in patients with COPD. Patients with COPD having the wheezing phenotype are associated with worse symptoms, more exacerbations, and worse lung function. ? 2015, Huang et al.
|ISSN:||1176-9106||DOI:||10.2147/COPD.S92062||SDG/Keyword:||beta adrenergic receptor stimulating agent; bronchodilating agent; corticosteroid; long acting drug; muscarinic receptor blocking agent; short acting drug; acute disease; adult; aged; Article; chronic obstructive lung disease; controlled study; demography; disease exacerbation; disease severity; female; forced expiratory volume; human; lung function; maintenance therapy; major clinical study; male; medical research; multicenter study (topic); phenotype; practice guideline; retrospective study; scoring system; symptom; Taiwan; wheezing; disease course; lung function test; pathophysiology; phenotype; physical examination; procedures; Pulmonary Disease, Chronic Obstructive; recurrent disease; Respiratory Sounds; severity of illness index; very elderly; Aged; Aged, 80 and over; Disease Progression; Female; Humans; Male; Phenotype; Physical Examination; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Respiratory Sounds; Retrospective Studies; Severity of Illness Index; Symptom Flare Up; Taiwan
|Appears in Collections:||醫學系|
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