{"id":23410,"date":"2026-01-23T16:44:20","date_gmt":"2026-01-23T21:44:20","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=23410"},"modified":"2026-03-17T16:45:14","modified_gmt":"2026-03-17T20:45:14","slug":"the-effect-of-copd-exacerbation-history-on-future-exacerbation-risk-and-mortality","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effect-of-copd-exacerbation-history-on-future-exacerbation-risk-and-mortality\/","title":{"rendered":"The effect of COPD exacerbation history on future exacerbation risk and mortality"},"content":{"rendered":"

Background<\/strong> \u2014 The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report classifies individuals with chronic obstructive pulmonary disease (COPD) who have experienced \u22652 moderate (outpatient) or \u22651 severe (emergency department or hospitalization) exacerbations within the last year as being at high risk of future exacerbation (category E).<\/p>\n

Objectives<\/strong> \u2014 This study aimed to investigate the risk of exacerbation and death associated with the individual components of the GOLD E category.<\/p>\n

Methods<\/strong> \u2014 We conducted a retrospective cohort study using health administrative data from Ontario, Canada (2007-2018). Individuals \u226565\u2009years of age with physician-diagnosed COPD were followed for up to 5 exacerbations, until their death, or the study period ended. After each exacerbation, individuals were assigned to 1 of 3 GOLD subgroups: E moderate (\u22652 moderate), E severe (\u22651 severe), and AB (\u22641 moderate). Under a landmark analysis framework, Fine-Gray subdistribution hazards (sdHR) competing risk models were created for each event, and the risk of exacerbation and death was estimated.<\/p>\n

Results<\/strong> \u2014 There were 279 798 individuals included. Individuals in the GOLD E moderate subgroup were at a higher risk of future exacerbation (COPD, chronic obstructive pulmonary disease exacerbations 3-5\u2009=\u20091.16-1.23) and a lower risk of death (sdHR exacerbations 3-5\u2009=\u20090.75-0.82) than GOLD AB individuals. In comparison, patients in the GOLD E severe subgroup were at lower risk of future exacerbation (sdHR exacerbations 2-5\u2009=\u20090.89-0.95), but higher risk of death (sdHR exacerbations 2-5\u2009=\u20091.56-1.59).<\/p>\n

Conclusions<\/strong> \u2014 These findings indicate that COPD patients in the GOLD E moderate subgroup have a different risk of future exacerbation and death than individuals in the GOLD E severe subgroup.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report classifies individuals with chronic obstructive pulmonary disease (COPD) who have experienced \u22652 moderate (outpatient) or \u22651 severe (emergency department or hospitalization) exacerbations within the last year as being at high risk of future exacerbation (category E). Objectives \u2014 This study aimed to […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[42,52],"migration-helper-qa-sample-set":[],"class_list":["post-23410","journal_article","type-journal_article","status-publish","hentry","topic-chronic-diseases-and-multimorbidity","topic-lung-health"],"acf":{"citation":"Munn JS, Sutradhar R, Butler SJ, Fidler L, Blazer AJ, Vanfleteren L, Gershon AS. Ann Am Thorac Soc<\/em>. 2026; 23(3): 379-389.","source_url":"https:\/\/doi.org\/10.1093\/annalsats\/aaoaf008","ices_scientist":[1370,20911,1244],"site":[6733],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | The effect of COPD exacerbation history on future exacerbation risk and mortality<\/title>\n<meta name=\"description\" content=\"Background \u2014 The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report classifies individuals with chronic obstructive pulmonary\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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