The St. George's Respiratory Questionnaire Definition of Chronic Bronchitis May Be a Better Predictor of COPD Exacerbations Compared With the Classic Definition

COPDGene Investigators

doi:10.1016/j.chest.2019.03.041

The St. George's Respiratory Questionnaire Definition of Chronic Bronchitis May Be a Better Predictor of COPD Exacerbations Compared With the Classic Definition

COPDGene Investigators

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Abstract

BACKGROUND: Chronic bronchitis (CB) increases risk of COPD exacerbations. We have shown that the St. George's Respiratory Questionnaire (SGRQ) CB definition identifies patients with a similar clinical phenotype as classically defined CB. Whether the SGRQ CB definition is a predictor of future COPD exacerbations is unknown.

METHODS: We analyzed 7,557 smokers with normal spirometry and Global Initiative for Chronic Obstructive Lung Disease stage 1-4 COPD in the Genetic Epidemiology of COPD study with longitudinal follow-up data on exacerbations. Subjects were divided into classic CB + or classic CB -, using the classic definition. In addition, subjects were divided into SGRQ CB + or SGRQ CB -. Exacerbation frequency and severe exacerbation frequency were determined in each group. Multivariable linear regressions were performed for exacerbation frequency with either classic CB or SGRQ CB and relevant covariates.

RESULTS: There were 1,434 classic CB + subjects and 2,290 SGRQ CB + subjects. The classic CB + group had a greater exacerbation frequency compared with the classic CB - group (0.69 ± 1.26 vs 0.36 ± 0.90 exacerbations per patient per year; P < .0001) and a greater severe exacerbation frequency (0.26 ± 0.74 vs 0.13 ± 0.46 severe exacerbations per patient per year; P < .0001). There were similar differences between the SGRQ CB + and SGRQ CB - groups. In multivariable analysis, both SGRQ CB and classic CB were independent predictors of exacerbation frequency, but SGRQ CB had a higher regression coefficient. In addition, SGRQ CB was an independent predictor of severe exacerbation frequency whereas classic CB was not.

CONCLUSIONS: The SGRQ CB definition identified more subjects at risk for future exacerbations than the classic CB definition. SGRQ CB was at least a similar if not better predictor of future exacerbations than classic CB.

Original language	English (US)
Pages (from-to)	685-695
Number of pages	11
Journal	CHEST
Volume	156
Issue number	4
DOIs	https://doi.org/10.1016/j.chest.2019.03.041
State	Published - Oct 2019

Bibliographical note

Publisher Copyright:
© 2019 American College of Chest Physicians

Keywords

COPD
chronic bronchitis
cough
exacerbations

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.chest.2019.03.041

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@article{c32bbcc82fd34fb6983d9a1067aad7f5,

title = "The St. George's Respiratory Questionnaire Definition of Chronic Bronchitis May Be a Better Predictor of COPD Exacerbations Compared With the Classic Definition",

abstract = "BACKGROUND: Chronic bronchitis (CB) increases risk of COPD exacerbations. We have shown that the St. George's Respiratory Questionnaire (SGRQ) CB definition identifies patients with a similar clinical phenotype as classically defined CB. Whether the SGRQ CB definition is a predictor of future COPD exacerbations is unknown.METHODS: We analyzed 7,557 smokers with normal spirometry and Global Initiative for Chronic Obstructive Lung Disease stage 1-4 COPD in the Genetic Epidemiology of COPD study with longitudinal follow-up data on exacerbations. Subjects were divided into classic CB + or classic CB -, using the classic definition. In addition, subjects were divided into SGRQ CB + or SGRQ CB -. Exacerbation frequency and severe exacerbation frequency were determined in each group. Multivariable linear regressions were performed for exacerbation frequency with either classic CB or SGRQ CB and relevant covariates. RESULTS: There were 1,434 classic CB + subjects and 2,290 SGRQ CB + subjects. The classic CB + group had a greater exacerbation frequency compared with the classic CB - group (0.69 ± 1.26 vs 0.36 ± 0.90 exacerbations per patient per year; P < .0001) and a greater severe exacerbation frequency (0.26 ± 0.74 vs 0.13 ± 0.46 severe exacerbations per patient per year; P < .0001). There were similar differences between the SGRQ CB + and SGRQ CB - groups. In multivariable analysis, both SGRQ CB and classic CB were independent predictors of exacerbation frequency, but SGRQ CB had a higher regression coefficient. In addition, SGRQ CB was an independent predictor of severe exacerbation frequency whereas classic CB was not. CONCLUSIONS: The SGRQ CB definition identified more subjects at risk for future exacerbations than the classic CB definition. SGRQ CB was at least a similar if not better predictor of future exacerbations than classic CB.",

keywords = "COPD, chronic bronchitis, cough, exacerbations",

author = "{COPDGene Investigators} and Victor Kim and Huaqing Zhao and Elizabeth Regan and Han, {Mei Lan K.} and Make, {Barry J.} and Crapo, {James D.} and Jones, {Paul W.} and Curtis, {Jeffrey L.} and Silverman, {Edwin K.} and Criner, {Gerard J.} and Regan, {Elizabeth A.} and Terri Beaty and Ferdouse Begum and Robert Busch and Castaldi, {Peter J.} and Michael Cho and DeMeo, {Dawn L.} and Boueiz, {Adel R.} and Foreman, {Marilyn G.} and Eitan Halper-Stromberg and Hansel, {Nadia N.} and Hardin, {Megan E.} and Hayden, {Lystra P.} and Hersh, {Craig P.} and Jacqueline Hetmanski and Hobbs, {Brian D.} and Hokanson, {John E.} and Nan Laird and Christoph Lange and Lutz, {Sharon M.} and McDonald, {Merry Lynn} and Parker, {Margaret M.} and Dandi Qiao and Stephanie Santorico and Wan, {Emily S.} and Sungho Won and Charbonnier, {Jean Paul} and Coxson, {Harvey O.} and Hoffman, {Eric A.} and Stephen Humphries and Jacobson, {Francine L.} and Judy, {Philip F.} and Kazerooni, {Ella A.} and Alex Kluiber and Charlene McEvoy and Joseph Tashjian and Christine Wendt and Joanne Billings and Abbie Begnaud and Tadashi Allen",

note = "Publisher Copyright: {\textcopyright} 2019 American College of Chest Physicians",

year = "2019",

month = oct,

doi = "10.1016/j.chest.2019.03.041",

language = "English (US)",

volume = "156",

pages = "685--695",

journal = "CHEST",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "4",

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TY - JOUR

T1 - The St. George's Respiratory Questionnaire Definition of Chronic Bronchitis May Be a Better Predictor of COPD Exacerbations Compared With the Classic Definition

AU - COPDGene Investigators

AU - Kim, Victor

AU - Zhao, Huaqing

AU - Regan, Elizabeth

AU - Han, Mei Lan K.

AU - Make, Barry J.

AU - Crapo, James D.

AU - Jones, Paul W.

AU - Curtis, Jeffrey L.

AU - Silverman, Edwin K.

AU - Criner, Gerard J.

AU - Regan, Elizabeth A.

AU - Beaty, Terri

AU - Begum, Ferdouse

AU - Busch, Robert

AU - Castaldi, Peter J.

AU - Cho, Michael

AU - DeMeo, Dawn L.

AU - Boueiz, Adel R.

AU - Foreman, Marilyn G.

AU - Halper-Stromberg, Eitan

AU - Hansel, Nadia N.

AU - Hardin, Megan E.

AU - Hayden, Lystra P.

AU - Hersh, Craig P.

AU - Hetmanski, Jacqueline

AU - Hobbs, Brian D.

AU - Hokanson, John E.

AU - Laird, Nan

AU - Lange, Christoph

AU - Lutz, Sharon M.

AU - McDonald, Merry Lynn

AU - Parker, Margaret M.

AU - Qiao, Dandi

AU - Santorico, Stephanie

AU - Wan, Emily S.

AU - Won, Sungho

AU - Charbonnier, Jean Paul

AU - Coxson, Harvey O.

AU - Hoffman, Eric A.

AU - Humphries, Stephen

AU - Jacobson, Francine L.

AU - Judy, Philip F.

AU - Kazerooni, Ella A.

AU - Kluiber, Alex

AU - McEvoy, Charlene

AU - Tashjian, Joseph

AU - Wendt, Christine

AU - Billings, Joanne

AU - Begnaud, Abbie

AU - Allen, Tadashi

PY - 2019/10

Y1 - 2019/10

N2 - BACKGROUND: Chronic bronchitis (CB) increases risk of COPD exacerbations. We have shown that the St. George's Respiratory Questionnaire (SGRQ) CB definition identifies patients with a similar clinical phenotype as classically defined CB. Whether the SGRQ CB definition is a predictor of future COPD exacerbations is unknown.METHODS: We analyzed 7,557 smokers with normal spirometry and Global Initiative for Chronic Obstructive Lung Disease stage 1-4 COPD in the Genetic Epidemiology of COPD study with longitudinal follow-up data on exacerbations. Subjects were divided into classic CB + or classic CB -, using the classic definition. In addition, subjects were divided into SGRQ CB + or SGRQ CB -. Exacerbation frequency and severe exacerbation frequency were determined in each group. Multivariable linear regressions were performed for exacerbation frequency with either classic CB or SGRQ CB and relevant covariates. RESULTS: There were 1,434 classic CB + subjects and 2,290 SGRQ CB + subjects. The classic CB + group had a greater exacerbation frequency compared with the classic CB - group (0.69 ± 1.26 vs 0.36 ± 0.90 exacerbations per patient per year; P < .0001) and a greater severe exacerbation frequency (0.26 ± 0.74 vs 0.13 ± 0.46 severe exacerbations per patient per year; P < .0001). There were similar differences between the SGRQ CB + and SGRQ CB - groups. In multivariable analysis, both SGRQ CB and classic CB were independent predictors of exacerbation frequency, but SGRQ CB had a higher regression coefficient. In addition, SGRQ CB was an independent predictor of severe exacerbation frequency whereas classic CB was not. CONCLUSIONS: The SGRQ CB definition identified more subjects at risk for future exacerbations than the classic CB definition. SGRQ CB was at least a similar if not better predictor of future exacerbations than classic CB.

AB - BACKGROUND: Chronic bronchitis (CB) increases risk of COPD exacerbations. We have shown that the St. George's Respiratory Questionnaire (SGRQ) CB definition identifies patients with a similar clinical phenotype as classically defined CB. Whether the SGRQ CB definition is a predictor of future COPD exacerbations is unknown.METHODS: We analyzed 7,557 smokers with normal spirometry and Global Initiative for Chronic Obstructive Lung Disease stage 1-4 COPD in the Genetic Epidemiology of COPD study with longitudinal follow-up data on exacerbations. Subjects were divided into classic CB + or classic CB -, using the classic definition. In addition, subjects were divided into SGRQ CB + or SGRQ CB -. Exacerbation frequency and severe exacerbation frequency were determined in each group. Multivariable linear regressions were performed for exacerbation frequency with either classic CB or SGRQ CB and relevant covariates. RESULTS: There were 1,434 classic CB + subjects and 2,290 SGRQ CB + subjects. The classic CB + group had a greater exacerbation frequency compared with the classic CB - group (0.69 ± 1.26 vs 0.36 ± 0.90 exacerbations per patient per year; P < .0001) and a greater severe exacerbation frequency (0.26 ± 0.74 vs 0.13 ± 0.46 severe exacerbations per patient per year; P < .0001). There were similar differences between the SGRQ CB + and SGRQ CB - groups. In multivariable analysis, both SGRQ CB and classic CB were independent predictors of exacerbation frequency, but SGRQ CB had a higher regression coefficient. In addition, SGRQ CB was an independent predictor of severe exacerbation frequency whereas classic CB was not. CONCLUSIONS: The SGRQ CB definition identified more subjects at risk for future exacerbations than the classic CB definition. SGRQ CB was at least a similar if not better predictor of future exacerbations than classic CB.

KW - COPD

KW - chronic bronchitis

KW - cough

KW - exacerbations

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U2 - 10.1016/j.chest.2019.03.041

DO - 10.1016/j.chest.2019.03.041

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AN - SCOPUS:85067359671

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VL - 156

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EP - 695

JO - CHEST

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ER -

The St. George's Respiratory Questionnaire Definition of Chronic Bronchitis May Be a Better Predictor of COPD Exacerbations Compared With the Classic Definition

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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