Journal article
Persistent and Newly Developed Chronic Bronchitis Are Associated with Worse Outcomes in Chronic Obstructive Pulmonary Disease
Annals of the American Thoracic Society, Vol.13(7), pp.1016-1025
07/2016
DOI: 10.1513/AnnalsATS.201512-800OC
PMCID: PMC5015750
PMID: 27158740
Abstract
Chronic bronchitis is, by definition, a chronic condition, but the development and remission of this condition in cigarette smokers with or without chronic obstructive pulmonary disease (COPD) are poorly understood. Also, it is unclear how the persistence or new development of chronic bronchitis affects symptoms and outcomes.
To ascertain the relationship between smoking status and the presence or absence of chronic bronchitis and the subsequent effects on symptoms and outcomes.
We analyzed 1,775 current or ex-smokers with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage 0-IV COPD in phase 2 of the Genetic Epidemiology of COPD (COPDGene) Study, which included subjects after 5 years of follow-up from phase 1. We asked subjects at enrollment and at 5 years of follow-up about symptoms consistent with chronic bronchitis. We divided subjects into four groups: persistent chronic bronchitis- (negative at phase 1/negative at phase 2), resolved chronic bronchitis (positive/negative), new chronic bronchitis (negative/positive), and persistent chronic bronchitis+ (positive/positive). We analyzed respiratory symptoms, health-related quality of life, lung function, exacerbation frequency, and 6-minute walk distance.
Compared with the persistent chronic bronchitis- group, members of the persistent chronic bronchitis+ group were more likely to have continued smoking (53.4%). Subjects with new chronic bronchitis were more likely to have resumed (6.6%) or continued smoking (45.6%), whereas subjects with resolved chronic bronchitis were more likely to have quit smoking (23.5%). Compared with the persistent chronic bronchitis- group, the other groups had a shorter 6-minute walk distance, worse lung function, greater exacerbation frequency, and worse respiratory symptoms. Modified Medical Research Council dyspnea and St. George's Respiratory Questionnaire scores worsened between phase 1 and phase 2 in subjects with new chronic bronchitis but improved in the resolved chronic bronchitis group. On multinomial logistic regression, quitting smoking conferred an odds ratio (OR) of 4.289 (95% confidence interval [CI], 2.689-6.842) for resolved chronic bronchitis, whereas resuming smoking had an OR of 4.585 (95% CI, 2.008-10.471) for new chronic bronchitis. Persistent smoking had an OR of 2.621 (95% CI, 1.677-4.096) and 5.767 (95% CI, 3.702-8.983) for subjects with new chronic bronchitis and subjects with persistent chronic bronchitis, respectively.
Persistent and newly developed chronic bronchitis are associated with continued or resumed smoking, greater respiratory symptoms, worse health-related quality of life, worse lung function, and greater exacerbation frequency. These findings stress the importance of repeatedly assessing chronic cough and sputum production in smokers to identify those at risk for poor outcomes.
Details
- Title: Subtitle
- Persistent and Newly Developed Chronic Bronchitis Are Associated with Worse Outcomes in Chronic Obstructive Pulmonary Disease
- Creators
- Victor Kim - 1 Temple University School of Medicine, Philadelphia, PennsylvaniaHuaqing Zhao - 1 Temple University School of Medicine, Philadelphia, PennsylvaniaAladin M Boriek - 2 Baylor College of Medicine, Houston, TexasAntonio Anzueto - 3 University of Texas Health Science Center at San Antonio, Medicine, San Antonio, TexasXavier Soler - 4 University of California San Diego School of Medicine, San Diego, CaliforniaSurya P Bhatt - 5 University of Alabama at Birmingham and UAB Lung Health Center, Birmingham, AlabamaStephen I Rennard - 6 University of Nebraska Medical Center, Omaha, NebraskaRobert Wise - 7 Johns Hopkins University School of Medicine, Baltimore, MarylandAlejandro Comellas - 8 University of Iowa, Iowa City, IowaJoe W Ramsdell - 4 University of California San Diego School of Medicine, San Diego, CaliforniaGregory L Kinney - 9 University of Colorado School of Public Health-Epidemiology, Denver, ColoradoMeiLan K Han - 10 University of Michigan Health Care System, Ann Arbor, MichiganCarlos H Martinez - 10 University of Michigan Health Care System, Ann Arbor, MichiganAndrew Yen - 11 Department of Radiology, University of California San Diego, San Diego, CaliforniaJennifer Black-Shinn - 12 University of Colorado School of Public Health, Aurora, ColoradoJanos Porszasz - 13 David Geffen School of Medicine University of California Los Angeles, Los Angeles, CaliforniaGerard J Criner - 1 Temple University School of Medicine, Philadelphia, PennsylvaniaNicola A Hanania - 2 Baylor College of Medicine, Houston, TexasAmir Sharafkhaneh - 2 Baylor College of Medicine, Houston, TexasJames D Crapo - 14 National Jewish Health, Denver, ColoradoBarry J Make - 14 National Jewish Health, Denver, ColoradoEdwin K Silverman - 15 Brigham and Women's Hospital, Boston, Massachusetts; andJeffrey L Curtis - 16 Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.13(7), pp.1016-1025
- DOI
- 10.1513/AnnalsATS.201512-800OC
- PMID
- 27158740
- PMCID
- PMC5015750
- NLM abbreviation
- Ann Am Thorac Soc
- ISSN
- 2325-6621
- eISSN
- 2325-6621
- Publisher
- American Thoracic Society; United States
- Grant note
- U01 HL089856 / NHLBI NIH HHS K23 HL128936 / NHLBI NIH HHS U01 HL089897 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS I01 CX000911 / CSRD VA R01 HL089897 / NHLBI NIH HHS K24 HL138188 / NHLBI NIH HHS K23 HL094696 / NHLBI NIH HHS
- Language
- English
- Date published
- 07/2016
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Psychiatry; ICTS; Internal Medicine
- Record Identifier
- 9984051522202771
Metrics
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