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Epidemiology and impact of chronic bronchitis in chronic obstructive pulmonary disease

Lies Lahousse (UGent) , Leen Seys (UGent) , Guy Joos (UGent) , Oscar H Franco, Bruno H Stricker and Guy Brusselle (UGent)
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Abstract
Research on the association between chronic bronchitis and chronic obstructive pulmonary disease (COPD) exacerbations has led to discordant results. Furthermore, the impact of chronic bronchitis on mortality in COPD subjects is unclear. Within the Rotterdam Study, a population-based cohort study of subjects aged >= 45 years, chronic bronchitis was defined as having a productive cough for >= 3 months per year for two consecutive years. Linear, logistic regression and Cox proportional hazard models were adjusted for age, sex and pack-years. Out of 972 included COPD subjects, 752 had no chronic phlegm production (CB-) and 220 had chronic phlegm production, of whom 172 met the definition of chronic bronchitis (CB+). CB+ subjects were older, more frequently current smokers and had more pack-years than CB-subjects. During a median 6.5 years of follow-up, CB+ subjects had greater decline in lung function (-38 mL.year(-1), 95% CI -61.7--14.6; p=0.024). CB+ subjects had an increased risk of frequent exacerbations (OR 4.0, 95% CI 2.7-5.9; p<0.001). In females, survival was significantly worse in CB+ subjects compared to CB-subjects. Regarding cause-specific mortality, CB+ subjects had an increased risk of respiratory mortality (hazard ratio 2.16, 95% CI 1.12-4.17; p=0.002). COPD subjects with chronic bronchitis have an increased risk of exacerbations and respiratory mortality compared to COPD subjects without chronic phlegm production.
Keywords
CHRONIC MUCUS HYPERSECRETION, FREQUENT EXACERBATIONS, COPD, EXACERBATIONS, N-ACETYLCYSTEINE, SEX-DIFFERENCES, LUNG-FUNCTION, RISK-FACTORS, PHENOTYPE, MORTALITY, DECLINE

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Chicago
Lahousse, Lies, Leen Seys, Guy Joos, Oscar H Franco, Bruno H Stricker, and Guy Brusselle. 2017. “Epidemiology and Impact of Chronic Bronchitis in Chronic Obstructive Pulmonary Disease.” European Respiratory Journal 50 (2).
APA
Lahousse, L., Seys, L., Joos, G., Franco, O. H., Stricker, B. H., & Brusselle, G. (2017). Epidemiology and impact of chronic bronchitis in chronic obstructive pulmonary disease. EUROPEAN RESPIRATORY JOURNAL, 50(2).
Vancouver
1.
Lahousse L, Seys L, Joos G, Franco OH, Stricker BH, Brusselle G. Epidemiology and impact of chronic bronchitis in chronic obstructive pulmonary disease. EUROPEAN RESPIRATORY JOURNAL. 2017;50(2).
MLA
Lahousse, Lies, Leen Seys, Guy Joos, et al. “Epidemiology and Impact of Chronic Bronchitis in Chronic Obstructive Pulmonary Disease.” EUROPEAN RESPIRATORY JOURNAL 50.2 (2017): n. pag. Print.
@article{8538277,
  abstract     = {Research on the association between chronic bronchitis and chronic obstructive pulmonary disease (COPD) exacerbations has led to discordant results. Furthermore, the impact of chronic bronchitis on mortality in COPD subjects is unclear. 
Within the Rotterdam Study, a population-based cohort study of subjects aged {\textrangle}= 45 years, chronic bronchitis was defined as having a productive cough for {\textrangle}= 3 months per year for two consecutive years. Linear, logistic regression and Cox proportional hazard models were adjusted for age, sex and pack-years. 
Out of 972 included COPD subjects, 752 had no chronic phlegm production (CB-) and 220 had chronic phlegm production, of whom 172 met the definition of chronic bronchitis (CB+). CB+ subjects were older, more frequently current smokers and had more pack-years than CB-subjects. During a median 6.5 years of follow-up, CB+ subjects had greater decline in lung function (-38 mL.year(-1), 95\% CI -61.7--14.6; p=0.024). CB+ subjects had an increased risk of frequent exacerbations (OR 4.0, 95\% CI 2.7-5.9; p{\textlangle}0.001). In females, survival was significantly worse in CB+ subjects compared to CB-subjects. Regarding cause-specific mortality, CB+ subjects had an increased risk of respiratory mortality (hazard ratio 2.16, 95\% CI 1.12-4.17; p=0.002). 
COPD subjects with chronic bronchitis have an increased risk of exacerbations and respiratory mortality compared to COPD subjects without chronic phlegm production.},
  articleno    = {1602470},
  author       = {Lahousse, Lies and Seys, Leen and Joos, Guy and Franco, Oscar H and Stricker, Bruno H and Brusselle, Guy},
  issn         = {0903-1936},
  journal      = {EUROPEAN RESPIRATORY JOURNAL},
  keyword      = {CHRONIC MUCUS HYPERSECRETION,FREQUENT EXACERBATIONS,COPD,EXACERBATIONS,N-ACETYLCYSTEINE,SEX-DIFFERENCES,LUNG-FUNCTION,RISK-FACTORS,PHENOTYPE,MORTALITY,DECLINE},
  language     = {eng},
  number       = {2},
  pages        = {10},
  title        = {Epidemiology and impact of chronic bronchitis in chronic obstructive pulmonary disease},
  url          = {http://dx.doi.org/10.1183/13993003.02470-2016},
  volume       = {50},
  year         = {2017},
}

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