Prevalence of treatable traits among patients with very severe COPD across STAR and GOLD classification: A multicenter cohort study.

OBJECTIVES

This study aimed to demonstrate the prevalence of treatable traits (TTs) and investigate the relationship between specific TTs and future exacerbation-related readmission risk among patients with very severe chronic obstructive pulmonary disease (COPD) across both STaging of Airflow obstruction by Ratio (STAR) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading system.

METHODS

A total of 589 hospitalised patients were included. Participants underwent a multidimensional assessment to characterise the TTs and were then followed up for one year. Cox regression analyses were used to determine the association between the TTs and future exacerbation-related readmission risk.

RESULTS

Hospitalised patients with very severe COPD exhibit a higher prevalence of TTs. In the STAR classification, TTs of bronchodilator reversibility, emphysema, frequent exacerbations, frequent hospital admission, O2 desaturation, dyspnoea, exercise intolerance, pathogen colonisation, underweight, diabetes and not adherence were significantly related with 'STAR 4'. In the GOLD classification, TTs including bronchodilator reversibility, frequent exacerbations, frequent hospital admission, O2 desaturation, dyspnoea, exercise intolerance, pathogen colonisation, underweight, heart failure, dyslipidemia, not adherence and indoor use of biomass/coal were significantly linked with 'GOLD 4'. Furthermore, Cox regression analysis showed that patients with STAR 4 exhibited seven TTs associated with future exacerbation-related readmission risk, whereas two TTs were predictors in patients with GOLD 4.

CONCLUSION

Patients with very severe COPD exhibited more TTs that require intervention. Additionally, specific TTs were associated with future exacerbation-related readmissions in patients with very severe COPD across STAR and GOLD classification, indicating their clinical utility of evaluating them.