Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients

ERJ Open Research · 6 authors, 6 centres

AI SUMMARY

FIDELITY 100%

POPULATION364 COPD patients hospitalised with a severe exacerbation at a single Dutch center

INTERVENTIONApplication of the Rome severity classification

COMPARISONComparison across mild, moderate, and severe classification groups

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AGENT 01 · STRUCTURED SUMMARY

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TL;DR

This study applied the new Rome classification to 364 COPD patients hospitalised for an exacerbation and found that most were moderate, with fewer severe or mild cases. The classification showed it could differentiate between events with different short-term mortality rates.

Full summary

725 CHARS

This post hoc cohort study applied the Rome severity classification to 364 COPD patients hospitalised for an exacerbation at Maastricht University Medical Center between 2011 and 2014. The classification distributed patients into mild (14.3%), moderate (56.0%), and severe (29.7%) groups. In-hospital mortality was 3.8% for mild, 6.9% for moderate, and 13.9% for severe events. Patients with severe exacerbations had more severe underlying disease, higher inflammatory markers, and lower oxygen saturation. The study found the Rome criteria could differentiate short-term mortality rates. The findings suggest the Rome criteria may help refine the heterogeneity of hospitalised exacerbations and aid clinical decision-making.

PICO

PPOPULATION

364 COPD patients hospitalised with a severe exacerbation at a single Dutch center

IINTERVENTION

Application of the Rome severity classification

OOUTCOME

In-hospital, 30-day, and 90-day all-cause mortality; clinical characteristics

STUDY TYPE

cohort

SPECIALTY

pulmonology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10204729

Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients

ERJ Open Research

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ABSTRACT

Background Recently, the Rome classification was proposed in which objective and readily measurable variables were integrated to mark exacerbations of COPD (ECOPD) severity. The aim of this study is to investigate the distribution of a real-world patient population with hospitalised ECOPD according to the current classification across the newly proposed severity classification. We assume that a significant proportion of hospitalised patients will have a mild or moderate event. Methods The Rome classification was applied to a cohort of 364 COPD patients hospitalised at the Department of Respiratory Medicine of Maastricht University Medical Center (MUMC) with a severe ECOPD. Differences in in-hospital, 30- and 90-day mortality were compared between mild, moderate and severe ECOPD according to the new classification. Moreover, data were stratified by the different severity classes and compared regarding general disease characteristics and clinical parameters. Results According to the Rome proposal, 52 (14.3%) patients had a mild ECOPD, 204 (56.0%) a moderate and 108 (29.7%) a severe ECOPD. In-hospital mortality in mild, moderate and severe events was 3.8%, 6.9% and 13.9%, respectively. Most clinical parameters indicated a significantly worse condition in patients classified in the severe group, compared to those in mild or moderate groups. Conclusion Most of the events, traditionally all classified as severe because of the hospitalisation, were classified as moderate, while almost 15% were mild. The results of this study provide insight into the heterogeneity of hospitalised ECOPD and show that the newly proposed Rome criteria can differentiate between events with different short-term mortality rates.

CITATION EXPORT

Carmen Reumkens, Adrian Endres, Sami O. Simons et al.. Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients. ERJ Open Research. (2023). https://doi.org/10.1183/23120541.00569-2022

AUTHORS

6 · 6 CENTRES

Carmen Reumkens, Adrian Endres, Sami O. Simons, Paul H.M. Savelkoul, Roy T.M. Sprooten, Frits M.E. Franssen

1Department of Medical Microbiology, Infectious Diseases and Infection Prevention, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
2Department of Respiratory Medicine and Allergology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
3Department of Respiratory Medicine, NUTRIM, MUMC+, Maastricht, The Netherlands
4Department of Respiratory Medicine, MUMC+, Maastricht, The Netherlands
5Department of Research and Education, Ciro, Horn, The Netherlands
6These authors contributed equally