PhD Scientific Days 2023

Clinical Medicine - Posters J

Past acute exacerbations predict future relapses in patients with chronic hypercapnic COPD receiving long-term non-invasive ventilation

Előadó neve

Dr. Balázs, Csoma

Neptun code

H8JRP3

Előadó munkahelye

Semmelweis University Department of Pulmonology

Előadó telefonszáma

+36703952161

Előadó e-mail címe

csoma.balazs@phd.semmelweis.hu

Az előadás címe

Past acute exacerbations predict future relapses in patients with chronic hypercapnic COPD receiving long-term non-invasive ventilation

Szerző(k) neve és munkahelye

Balázs Csoma1, András Bikov2,3, Veronika Müller1, Zsófia Lázár1
1 Semmelweis University, Department of Pulmonology, Budapest, Hungary
2 Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
3 The University of Manchester, Faculty of Biology, Medicine and Health, Division of Infection, Immunity & Respiratory Medicine, Manchester, United Kingdom

Bemutatás módja

Poszter

Szekció

Clinical Medicine - Posters J

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Chronic hypercapnia modulates airway inflammation and can increase the risk for acute exacerbations (AE) in patients with COPD. Exacerbations in the past are associated with future flare-ups. Reducing hypercapnia with long-term non-invasive ventilation (LT-NIV) may decrease the risk for AE; however, it is unclear if patients with a high burden of AE before LT-NIV are still at higher risk for future AE post set up.
Aims: To determine the effect of normalising hypercapnia on the annual acute exacerbation rate in severe COPD.
Methods: Fifty-six (age: 64±9 yrs, 41% male) patients receiving LT-NIV were enrolled and followed up until the end of the data collection period or the death of the patient (median follow-up: 21.5 [IQR=4-51] months). Exacerbation history (moderate and severe), smoking history, blood eosinophil count, and capillary blood gas parameters were recorded at the time of enrolment and at follow-up visits. Treatment adherence was regularly monitored. Annualized AE rate was calculated to adjust for the different follow-up durations. Predictors of AE rate were investigated with linear regression models.
Results: The median AE rate (3 [2-5] vs. 2 [0-4] AE/year, p<0.001) and blood carbon dioxide levels (62.3±20.3 vs. 48.0±9.0 Hgmm, p<0.001) decreased significantly after the initiation on LT-NIV. 49 (88%) patients were adherent (>4 h/day usage) to the therapy. Excluding the non-adherent patients, we found that AE rate pre-setup was independently related to later events (β=0.51, p<0.01, whole model R2=0.54, p<0.01).
Conclusion: Although LT-NIV reduces the number of AEs in patients with COPD, those who had a higher burden of AEs are still at risk for developing future events.
Funding: Balázs Csoma was supported by the SE 250+ PhD Excellence Program, the National Talent Program of the Hungarian Prime Ministry, and the Hungarian State Eötvös Scholarship of the Tempus Public Foundation.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Dr. Zsófia Lázár

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

7382

Start

11:00

End

11:05

Authors (legacy)

Balázs Csoma1, András Bikov2,3, Veronika Müller1, Zsófia Lázár1
1 Semmelweis University, Department of Pulmonology, Budapest, Hungary
2 Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
3 The University of Manchester, Faculty of Biology, Medicine and Health, Division of Infection, Immunity & Respiratory Medicine, Manchester, United Kingdom