“Accurate prediction is important because weighing the individual risk estimates against the benefit and harm of treatment can help to assist clinical decision-making and guide resource allocation,” explained PhD student Spencer Keene (Maastricht University, the Netherlands). Various prediction tools for COPD exacerbations have been developed, but only the Birmingham Lung Improvement Studies (BLISS) prognostic score (including 6 variables: age, CAT score, respiratory admissions previous 12m, BMI, diabetes, and FEV1% predicted) and the Bertens’ score (including 4 variables: exacerbations in the previous year, pack years of smoking, level of obstruction, and history of vascular disease) have methodological rigour and practicality [2,3]. They have been tested in primary care patients but not in more severe COPD patients with at least 1 moderate-to-severe exacerbation within 2-years. Thus, Mr Keene and colleagues tested these scores in the COPD cohort of the observational, multicentre ECLIPSE study.
The cohort included 1,749 COPD participants (mean age 63 years; 35% female), of whom 1,214 (69%) had >1 exacerbation within 2-years. The BLISS score showed good discrimination and accurately predicted severe exacerbation in the ECLIPSE COPD patients. It performed better than the Bertens’ score. However, due to systematic under-prediction of risk, neither score should be used to predict moderate-to-severe exacerbations.
- Keene S. External validation of two prognostic scores predicting exacerbations in ECLIPSE COPD patients. Abstract 4192, ERS International Virtual Congress 2020, 7-9 Sept.
- Jordan R, et al. Eur Respir J 2019;54:Suppl.63, OA257.
- Bertens LC, et al. Int J Chron Obstruct Pulmon Dis 2013;8:493-499.
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Table of Contents: ERS 2020
Featured articles
COVID-19 and the Lung
COVID-19 infections: Bronchoscopy provides additional diagnostic certainty
COVID-19 vaccines: An ongoing race
COVID-19: What is the risk of reinfection?
COVID-19 App: The Dutch experience
Secondary pulmonary fibrosis: a possible long-term effect of severe COVID-19
COVID-19 survivors benefit from structured follow-up
Early pulmonary rehabilitation post-COVID-19 aids recovery
Asthma – What's New
Mild asthma: A fundamental change in management
Dupilumab shows long-term efficacy in asthma patients
Severe asthma: Oral corticosteroids maintenance therapy associated with toxicity
First-in-class tyrosine kinase inhibitor shows promise in severe asthma
Predicting individual effectiveness of biologics in severe asthma
IL-5 antagonist showed efficacy in chronic rhinosinusitis with nasal polyps
Treatment according to genotype: The future of asthma therapy?
COPD – The Beat Goes On
The role of chronic symptoms as early biomarkers of COPD development
Urgent call for studies in COPD patients aged 40-60 years
Nasal high-flow therapy: a novel treatment option for hypercapnic COPD patients
Exacerbation history is a reliable predictor of future exacerbations
Singing training effective as physical rehabilitation in COPD
Current prediction tools underestimate exacerbation risk of severe COPD patients
Exercise and Sleep: From Impaired Function to New Therapeutic Strategies
CPAP withdrawal has negative consequences for sleep apnoea patients
Physical activity improves AHI in sleep apnoea patients
The Tobacco Epidemic: From Vaping to Cannabis
Poly-use of nicotine products and cannabis: a deadly combination
E-cigarettes: A source of chronic lung inflammation
Social smoking: Do not underestimate the risks
Chronic Cough – State of the Art
LEAD study shows multiple phenotypes in many chronic cough patients
First-in-class P2X3 receptor antagonist shows promise for chronic cough treatment
Lung Cancer Detection
Lung cancer screening: Most patients not eligible 1-2 years prior to diagnosis
Distinct changes in lung microbiome precede clinical diagnosis of lung cancer
Best of Posters
Smartphone-based cough detection helpful in predicting asthma deterioration
Reduced lung function associated with cognitive decline in the elderly
Longer hospital stay and fewer transplants for frail ILD patients
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