Exacerbation-like respiratory symptoms in individuals without chronic obstructive pulmonary disease: results from a population-based study. Issue 8 (4th April 2014)

• Record Type: Journal Article
• Authors: Tan, W C; Bourbeau, J; Hernandez, P; Chapman, K R; Cowie, R; FitzGerald, J M; Marciniuk, D D; Maltais, F; Buist, A S; O'Donnell, D E; Sin, D D; Aaron, S D
• Other Names: Samet Jonathon author non-byline.; Puhan Milo author non-byline.; Hamid Qutayba author non-byline.; Hogg James C author non-byline.; Bourbeau Jean author non-byline.; Tan Wan C author non-byline.; Jabet Carole author non-byline.; Sedona Maria author non-byline.; Mancino Palmina author non-byline.; Fortier Yvan author non-byline.; Sin Don author non-byline.; Li Yuexin author non-byline.; Tam Sheena author non-byline.; Comeau Joe author non-byline.; Ng Adrian author non-byline.; Coxson Harvey author non-byline.; Candido Tara author non-byline.; Leipsic Jonathon author non-byline.; Hague Cameron author non-byline.; Road Jeremy author non-byline.; Benedetti Andrea author non-byline.; Mara Carlo author non-byline.; Savafi Mohsen author non-byline.; Gershon Andrea author non-byline.; To Teresa author non-byline.; Tan Wan C author non-byline.; Coxson Harvey author non-byline.; Bourbeau Jean author non-byline.; Pei Zhi L author non-byline.; Jensen Denis author non-byline.; O'Donnell Denis author non-byline.; Tan Wan C author non-byline.; Lo Christine author non-byline.; Min Jeong author non-byline.; Moy Carly author non-byline.; Lau Anna La author non-byline.; Sran Ashleigh author non-byline.; Swanson Ebony author non-byline.; Yuan Ying author non-byline.; Chen Daniel author non-byline.; Zheng Lu author non-byline.; Yang Tina author non-byline.; Chuang Junior author non-byline.; Guo Best author non-byline.; Li Licong author non-byline.; Chan Kendall author non-byline.; Khanam Rahmath author non-byline.; Maslennikova Daria author non-byline.; Cheng Sarah author non-byline.; Peng Catherine author non-byline.; Chiang Bryan author non-byline.; Guo Sarah author non-byline.; Payne Kyrsten author non-byline.; Bourbeau Jean author non-byline.; Mancino Palmina author non-byline.; Sedona Maria author non-byline.; Darauay Carmen author non-byline.; Costa Myriam author non-byline.; Chapman Kenneth author non-byline.; McClean Patricia author non-byline.; Sporn Heather author non-byline.; Cowie Robert author non-byline.; Cowie Ann author non-byline.; Dumonceaux Curtis author non-byline.; Moore Jessica author non-byline.; Hernandez Paul author non-byline.; Fulton Scott author non-byline.; Yorke Maria author non-byline.; Fiorotos Natalie author non-byline.; Rowe Ashley author non-byline.; Aaron Shawn author non-byline.; Vandemheen Kathy author non-byline.; Pratt Gay author non-byline.; Srighanthan Jeevitha author non-byline.; O'Donnell Denis author non-byline.; Webb Kathy author non-byline.; Amornputtisathaporn Naparat author non-byline.; Cheung Kate author non-byline.; Whelan Kate author non-byline.; Cheng Jenny author non-byline.; Maltais Francois author non-byline.; Couture Joanie author non-byline.; Garcia Pereira Luciana author non-byline.; Breton Marie-Josée author non-byline.; Brouillard Cynthia author non-byline.; Marciniuk Darcy author non-byline.; Clemens Ron author non-byline.; Baran Janet author non-byline.;
• Is Part Of: Thorax. Volume 69:Issue 8(2014)
• Page Start: 709
• Page End: 717
• Publication Date: 2014-04-04
• Subjects: Clinical Epidemiology -- COPD Exacerbations -- Asthma Epidemiology; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2013-205048
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Rationale: Exacerbations of COPD are defined clinically by worsening of chronic respiratory symptoms. Chronic respiratory symptoms are common in the general population. There are no data on the frequency of exacerbation-like events in individuals without spirometric evidence of COPD. Aims: To determine the occurrence of 'exacerbation-like' events in individuals without airflow limitation, their associated risk factors, healthcare utilisation and social impacts. Method: We analysed the cross-sectional data from 5176 people aged 40 years and older who participated in a multisite, population-based study on lung health. The study cohort was stratified into spirometrically defined COPD (post-bronchodilator FEV1 /FVC < 0.7) and non-COPD (post bronchodilator FEV1 /FVC ≥ 0.7 and without self-reported doctor diagnosis of airway diseases) subgroups and then into those with and without respiratory 'exacerbation-like' events in the past year. Results: Individuals without COPD had half the frequency of 'exacerbation-like' events compared with those with COPD. In the non-COPD group, the independent associations with 'exacerbations' included female gender, presence of wheezing, the use of respiratory medications and self-perceived poor health. In the non-COPD group, those with exacerbations were more likely than those without exacerbations to have poorer health-related quality of life (12-item Short-Form Health Survey), miss social activities (58.5% vs 18.8%), miss work for income (41.5% vs 17.3%) and miss housework (55.6% vs 16.5%), p<0.01 to <0.0001. Conclusions: Events similar to exacerbations of COPD can occur in individuals without COPD or asthma and are associated with significant health and socioeconomic outcomes. They increase the respiratory burden in the community and may contribute to the false-positive diagnosis of asthma or COPD.