Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases

OBJECT This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy. METHODS The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records. RESULTS Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03). CONCLUSIONS Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.

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Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211015959 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110159

Author(s):

Jung Eun Yoo ◽

Dahye Kim ◽

Hayoung Choi ◽

Young Ae Kang ◽

Kyungdo Han ◽

...

Keyword(s):

Physical Activity ◽

Screening Program ◽

Chronic Obstructive ◽

Older Population ◽

Timed Up And Go ◽

Obstructive Pulmonary Disease ◽

Mild Anemia ◽

Increased Risk ◽

Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

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Abstract 16961: Time-dependent Markers of Chronic Obstructive Pulmonary Disease Severity and Change are Associated With Increased Risk of Mortality in the General Heart Failure Population: A National Study of 50,114 Patients From the United Kingdom

Circulation ◽

10.1161/circ.132.suppl_3.16961 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Claire A Rushton ◽

Lucy Riley ◽

Duwarakan K Satchithananda ◽

Peter W Jones ◽

Umesh T Kadam

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Forced Expiration ◽

Obstructive Pulmonary Disease ◽

Gold Stage ◽

Risk Of Mortality ◽

Increased Risk

Purpose: Heart failure (HF) carries poor prognosis which changes over time. Chronic obstructive pulmonary disease (COPD) is common in HF and increases risk of mortality but how COPD severity and change influences HF prognosis is unknown. We hypothesised that in the HF general population, comorbidity stratification by increasing severity and longitudinal change would be associated with increased mortality. Methods: We used a case-control study nested within the UK Clinical Practice Research Datalink database (12-year time-period to 2014), of newly diagnosed HF patients aged over 40 years. Using risk set sampling, four controls were matched to cases on calendar and follow-up time. Routinely collected clinical measures of severity and change for COPD were (i) forced expiration volume in 1 second (FEV 1 ) stages, defined by Global Initiatives for Chronic Obstructive Lung Disease (GOLD) guidelines and (ii) prescribed medications in two time-windows covering 1-year prior to the match date. Conditional logistic regression was used to estimate risk ratios (RR) for all-cause mortality adjusted for known confounders. Results: Of the 50,114 HF sample, 5,848 (11.7%) had COPD and of these 62% died during follow-up compared to 52% of patients without COPD. COPD comorbidity risk associated with mortality stratified by GOLD stages was as follows: stage 1; adjusted RR 1.73 (95% CI 1.50-1.99) to stage 4; 3.14 (2.65, 3.73). Estimates for COPD FEV 1 change compared to no COPD were: GOLD stage same or better; 2.15 (1.97, 2.34) and GOLD stage worse; 2.70 (2.30, 3.17). The mortality estimates for medications severity were: inhalers only 1.13 (1.07,1.19), oral steroids; 1.83 (1.69,1.97) and oxygen; 2.94 (2.47, 3.51). The estimates for medications change were: no new steroids or oxygen; 1.22, (1.16, 1.28), new steroids but not oxygen; 1.84, (1.67,1.28) and new on oxygen; 3.41, (2.71,4.29). Conclusions: COPD is an important and common comorbidity in HF. Our results show that worse COPD severity and recent change based on routinely collected clinical data was associated with increased mortality and provides key prognostic information for clinical assessment in practice.

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Relation between Chronic Obstructive Pulmonary Disease and Peripheral Arterial Disease among Construction Workers

10.53350/pjmhs2115103473 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3473-3475

Author(s):

U. Sivakumar ◽

Rinku Garg ◽

Sunita Nighute

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Peripheral Arterial Disease ◽

Pulmonary Disease ◽

Arterial Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Risk Of Death ◽

Increased Risk ◽

Peripheral Arterial

Introduction: PAD was asymptomatic in a large proportion of COPD patients and was associated with more severe lung disease than in COPD subjects without PAD. Materials and Methods: This was a Cross-sectional study conducted at Department of Physiology, Santosh Medical College diagnosed with COPD using Spirometry was recruited for the study with a Sample size of 130 patients. Results: The characteristics of the population for follow-up (n=130) are presented in table 1. The mean Mean±SD was 51.73±6.1 years. The prevalence of never smokers was 21.5%, former smokers were 51.5% and current smokers were 26.9%. In total, 41 out of 130 individuals (31.5%) had PAD based on an ABI of less than 0.6. A statistically significant association was found between COPD and newly diagnosed PAD during follow-up. The association between COPD and incident PAD was stronger (adjusted OR 1.91, 95% CI 1.14–3.21). Stratified analysis by smoking status revealed that the overall association between COPD and newly developed PAD was driven by the ever smoker group. Conclusion: Subjects with COPD have a higher risk of developing PAD. People with both COPD and PAD have a substantially increased risk of death. Consequently, early detection of PAD and preventive actions in people with COPD should receive more attention in clinical respiratory care. Keywords: Peripheral Arterial Disease, Chronic Obstructive Pulmonary Disease, Ankle-brachial index.

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Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease

Journal of Dental Research ◽

10.1177/0022034519833630 ◽

2019 ◽

Vol 98 (5) ◽

pp. 534-540 ◽

Cited By ~ 11

Author(s):

K. Takeuchi ◽

K. Matsumoto ◽

M. Furuta ◽

S. Fukuyama ◽

T. Takeshita ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Population Attributable Fraction ◽

Community Dwelling ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Increased Risk ◽

Severe Periodontitis ◽

The Relationship

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

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General Practitioner, 7 years’ experience, UK

Non-Epileptic Seizures in Our Experience ◽

10.1093/med/9780190927752.003.0061 ◽

2020 ◽

pp. 168-170

Author(s):

Markus Reuber ◽

Gregg H. Rawlings ◽

Steven C. Schachter

Keyword(s):

Medical Records ◽

Discharge Summary ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Prolonged Seizure ◽

Neurology Clinic ◽

Acute Symptomatic Seizure ◽

Epileptic Attack ◽

Generalized Epilepsy

This chapter details the stories of two patients which illustrate the confusion and uncertainty that surrounds Non-Epileptic Attack Disorder (NEAD). The first patient has multiple health problems. His medical records list the following diagnoses: reflex anoxic seizures, epilepsy, NEAD, Chronic Obstructive Pulmonary Disease (COPD), heart failure, anemia, and a small meningioma. On a busy on-call, he presented with acute confusion, fever, and tachycardia. Once on the ward, he had a prolonged seizure. This was diagnosed as an acute symptomatic seizure and follow-up in the Neurology clinic was arranged. The patient did not attend the follow-up appointment, but he had another seizure a few weeks later in the street. An ambulance took him to the hospital and the very brief discharge summary referred to “dissociative epilepsy.” Unfortunately, the patient declined psychotherapy because the seizures were “not in his mind.” He was equally reluctant to start other antiepileptic drugs in addition to his long list of other medications. Meanwhile, the second patient’s medical records referred to localization-related epilepsy, generalized epilepsy, and NEAD. However, like the first patient, the second patient resisted psychotherapy.

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Low miR-150-5p and miR-320b Expression Predicts Reduced Survival of COPD Patients

Cells ◽

10.3390/cells8101162 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1162 ◽

Cited By ~ 6

Author(s):

Andreas Keller ◽

Nicole Ludwig ◽

Tobias Fehlmann ◽

Mustafa Kahraman ◽

Christina Backes ◽

...

Keyword(s):

Chronic Obstructive ◽

Expression Change ◽

Obstructive Pulmonary Disease ◽

Risk Of Death ◽

Copd Patients ◽

Genome Wide ◽

Increased Risk ◽

Individual Survival ◽

Molecular Profiles

Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of death, reducing life expectancy on average between 5 and 7 years. The survival time after diagnosis, however, varies considerably as a result of the heterogeneity of COPD. Therefore, markers that predict individual survival of COPD patients are of great value. We analyzed baseline molecular profiles and collected 54 months of follow-up data of the cohort study “COPD and SYstemic consequences-COmorbidities NETwork” (COSYCONET). Genome-wide microRNA signatures from whole blood collected at time of the inclusion in the study were generated for 533 COPD patients including patients that deceased during the 54-month follow-up period (n = 53) and patients that survived this period (n = 480). We identified two blood-born microRNAs (miR-150-5p and miR-320b) that were highly predictive for survival of COPD patients. The expression change was then confirmed by RT-qPCR in 245 individuals. Ninety percent of patients with highest expression of miR-150-5p survived the 54-month period in contrast to only 50% of patients with lowest expression intensity. Moreover, the abundance of the oncogenic miR-150-5p in blood of COPD patients was predictive for the development of cancer. Thus, molecular profiles measured at the time of a COPD diagnosis have a high predictive power for the survival of patients.

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Risk of asbestosis, mesothelioma, other lung disease or death among motor vehicle mechanics: a 45-year Danish cohort study

Thorax ◽

10.1136/thoraxjnl-2020-215041 ◽

2021 ◽

pp. thoraxjnl-2020-215041

Author(s):

Reimar Wernich Thomsen ◽

Anders Hammerich Riis ◽

Esben Meulengracht Flachs ◽

David H Garabrant ◽

Jens Peter Ellekilde Bonde ◽

...

Keyword(s):

Lung Cancer ◽

Malignant Mesothelioma ◽

Lung Diseases ◽

Motor Vehicle ◽

Disease Risk ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Increased Risk ◽

External Agents

IntroductionThe risk of asbestosis, malignant mesothelioma and lung cancer among motor vehicle mechanics is of concern because of potential exposure to chrysotile asbestos during brake, clutch and gasket repair and maintenance. Asbestos has also been used in insulation and exhaust systems.MethodsWe examined the long-term risk of incident mesothelioma, lung cancer, asbestosis and other lung diseases and mortality due to mesothelioma, lung cancer, asbestosis and other lung diseases in a nationwide cohort of all men registered as motor vehicle mechanics since 1970 in Denmark. This was compared with the corresponding risk in a cohort of male workers matched 10:1 by age and calendar year, with similar socioeconomic status (instrument makers, dairymen, upholsterers, glaziers, butchers, bakers, drivers, farmers and workers in the food industry, trade or public services).ResultsOur study included 138 559 motor vehicle mechanics (median age 24 years; median follow-up 20 years (maximum 45 years)) and 1 385 590 comparison workers (median age 25 years; median follow-up 19 years (maximum 45 years)). Compared with other workers, vehicle mechanics had a lower risk of morbidity due to mesothelioma/pleural cancer (n=47 cases) (age-adjusted and calendar-year-adjusted HR=0.74 (95% CI 0.55 to 0.99)), a slightly increased risk of lung cancer (HR=1.09 (95% CI 1.03 to 1.14)), increased risk of asbestosis (HR=1.50 (95% CI 1.10 to 2.03)) and a chronic obstructive pulmonary disease risk close to unity (HR=1.02 (95% CI 0.99 to 1.05)). Corresponding HRs for mortality were 0.86 (95% CI 0.64 to 1.15) for mesothelioma/pleural cancer, 1.06 (95% CI 1.01 to 1.12) for lung cancer, 1.79 (95% CI 1.10 to 2.92) for asbestosis, 1.06 (95% CI 0.86 to 1.30) for other lung diseases caused by external agents and 1.00 (95% CI 0.98 to 1.01) for death due to all causes.ConclusionsWe found that the risk of asbestosis was increased among vehicle mechanics. The risk of malignant mesothelioma/pleural cancers was not increased among vehicle mechanics.

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Abstract 14962: Empagliflozin’s Cardiovascular Impact in High-Risk Patients With Type 2 Diabetes and Obstructive Pulmonary Disease: An Inquiry From EMPA-REG OUTCOME

Circulation ◽

10.1161/circ.142.suppl_3.14962 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Stefan D Anker ◽

David H Fitchett ◽

Bernard Zinman ◽

Anne Pernille Ofstad ◽

Christoph Wanner ◽

...

Keyword(s):

Type 2 Diabetes ◽

Pulmonary Disease ◽

Cox Regression ◽

Baseline Risk ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Similar Treatment ◽

Increased Risk

Introduction: Type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD) often co-exist yielding increased risk of cardiovascular (CV) complications, including heart failure (HF). In the EMPA-REG OUTCOME trial, empagliflozin (EMPA) reduced the risk of CV death and hospitalization for HF (HHF) in patients with T2D and CV disease (CVD). We hypothesized that patients with COPD had a higher risk of CV outcomes than those without COPD, but similar treatment benefits on CV outcomes from EMPA as the overall population. Methods: In total, 7020 patients were treated with EMPA 10mg, 25mg, or placebo (PBO) with median follow-up of 3.1 years. We defined COPD at baseline (BL) by investigator reported presence of COPD or emphysema, or the use of medications for obstructive airways disease. We explored the effect of pooled EMPA groups vs. PBO within the subgroups of patients with vs. without COPD on CV death, HHF, HHF or CV death (excluding fatal stroke), all-cause death and 3-point-MACE by Cox regression adjusted for baseline risk factors. Results: The 707 (10.1%) patients with COPD at BL were slightly older (65±8 vs. 63±9 yrs), had more often HF at BL (17 vs. 9%) and coronary artery disease (84 vs. 75%), used insulin (56 vs. 47%) and diuretics (57 vs. 42%,) more frequently, but had similar beta-blocker use (64 vs. 65%) as compared to those without COPD. During follow-up, those with COPD in the placebo group had increased risk of HHF (HR 2.15 [95%CI 1.32-3.49], p=0.002), HHF or CV death (HR 1.60 [1.10-2.33], p<0.015), and all-cause death (HR 1.60 [1.09-2.35], p<0.02). EMPA consistently reduced all CV outcomes irrespective of COPD status (Fig). Conclusions: In EMPA-REG OUTCOME, 10% of patients had concomitant COPD. COPD patients were at increased risk of HHF, HHF or CV death, as well as all-cause death. EMPA consistently reduced these outcomes vs PBO among patients with and without COPD. These data suggest that EMPA’s benefits in patients with T2D and CVD are not attenuated by presence of COPD.

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Risk and clinical predictors of osteoporotic fracture in East Asian patients with chronic obstructive pulmonary disease: a population-based cohort study

PeerJ ◽

10.7717/peerj.2634 ◽

2016 ◽

Vol 4 ◽

pp. e2634 ◽

Cited By ~ 6

Author(s):

Ping-Hsueh Lee ◽

Victor C. Kok ◽

Po-Liang Chou ◽

Ming-Chang Ku ◽

Yu-Ching Chen ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

East Asian ◽

Population Based ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Asian Patients ◽

Copd Patients ◽

Increased Risk

IntroductionOsteoporosis is becoming an impending epidemic in the Asia-Pacific region. The association between risk of osteoporotic fracture (OTPF) and chronic obstructive pulmonary disease (COPD) in East Asian patients is yet to be fully examined. We conducted a nationwide population-based retrospective cohort study of 98,700 patients aged ≥50 years with or without COPD using a national administrative claims dataset.Materials and MethodsThe patients were divided into COPD and comparison groups comprising 19,740 and 78,960 patients, respectively. The groups were 1 to 4 matched for age, gender, index date, diabetes mellitus, pre-existing osteoporosis and chronic kidney disease. Information such as the geographic area where southern part represented more sunshine exposure, smoking-related diagnoses, alcohol use disorder, whether there was regular use of inhaled corticosteroids and oral corticosteroids, vitamin D prescriptions, Charlson-Deyo comorbidity index score, and other relevant medical comorbidities were extracted for analysis. They were followed up until OTPF or the end of the year 2013. The outcome measure was an osteoporotic vertebral fracture and other long-bone fractures. A multivariate Cox model was constructed to derive adjusted hazard ratios (aHR) for OTPF with corresponding 95% confidence intervals (CI) after controlling for age, sex, insurance premium category, vitamin D prescription, osteoporosis, and coronary heart disease (CHD). Kaplan–Meier curves of the probability of OTPF-free survival for each cohort were compared using the log-rank test. Patients with OTPF during the first follow-up year were excluded from the overall risk calculation. Contributing factors to the increased risk of OTPF in COPD patients were examined in a sensitivity analysis.ResultsAfter a total follow-up of 68,743 patient-years for the COPD group and 278,051 patient-years for the matched comparison group, the HR for OTPF was 1.24 (95% CI [1.02–1.51];P = 0.0322) in COPD patients. The aHR was increased by 30% for vertebral OTPF (aHR = 1.297, 95% CI [1.020–1.649];P = 0.0339). Differential lag time sensitivity analysis revealed a progressively elevated risk up to 8-fold increase in women (aHR = 8.0 (95% CI [1.81–35.4];P < 0.01)) during the fifth follow-up year. COPD patients with pre-existing osteoporosis or given vitamin D prescription harbor a sustained increased risk up to the 5th (aHR, 4.1; 95% CI [1.61–10.35]) and third (aHR, 2.97; 95% CI [1.48–5.97]) follow-up year, respectively.ConclusionsOur nationwide population-based cohort study demonstrates that East Asian COPD patients aged 50 and beyond do harbor a modestly increased risk for osteoporotic vertebral fractures particularly for those who are female, have pre-existing osteoporosis or require vitamin D prescription.

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Persistently elevated exhaled nitric oxide fraction is associated with increased risk of exacerbation in COPD

European Respiratory Journal ◽

10.1183/13993003.01457-2017 ◽

2018 ◽

Vol 51 (1) ◽

pp. 1701457 ◽

Cited By ~ 19

Author(s):

Bernardino Alcázar-Navarrete ◽

Oliverio Ruiz Rodríguez ◽

Pablo Conde Baena ◽

Pedro José Romero Palacios ◽

Alvar Agusti

Keyword(s):

Nitric Oxide ◽

Exhaled Nitric Oxide ◽

Rank Test ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Increased Risk ◽

Confounding Variables ◽

Acute Exacerbations

Preventing the occurrence of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a major therapeutic goal. We hypothesise that persistently increased levels of exhaled nitric oxide (FeNO) during follow-up can identify a group of COPD patients at higher risk of AECOPD.To test this hypothesis, we measured FeNO levels (HypAir FeNO®, Medisoft; Sorinnes, Belgium) prospectively in 226 clinically stable COPD outpatients at recruitment and during follow-up (at 6 and 12 months). Patients were stratified according to the number of visits with FeNO ≥20 ppb.FeNO was <20 ppb in all three visits in 44.2% of patients, 29.6% in visit 1 and 26.1% in visit 2 or 3. These three groups suffered progressively higher AECOPD rates during follow-up (0.67, 0.91 and 1.42, respectively, p<0.001). After adjusting for potential confounding variables (log-rank test), the hazard ratio for AECOPD was higher in the latter group (1.579 (95% CI 1.049–2.378), p=0.029). Likewise, time to first moderate and severe AECOPD was shorter in these patients. Finally, there was no relationship between FeNO levels and circulating eosinophils.Persistent FeNO levels ≥20 ppb in clinically stable COPD outpatients are associated with a significantly higher risk of AECOPD.

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