A Seasonal Asthma Exacerbation Predictive Index (saEPI) was previously reported based on 2 prior National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium trials.
For most of the disease groups, the results indicated that patients who had received an annual follow-up had a lower OR for exacerbation at index contact than other patients, although this association did not reach statistical significance.
This higher use was also seen in the increased OR for exacerbation at index contact with daytime GP compared to patients without one of the five chronic diseases (Table 5).
Our findings enable us to conclude that CRP levels are not associated with the pulmonary exacerbation severity index but that they are associated with some clinical variables, such as colonization by P. aeruginosa, number of exacerbations treated with intravenous antibiotics during the previous year, treatment with oral corticosteroids, and allergic bronchopulmonary aspergillosis.
Readmission within 30 days of the index exacerbation for the same reason, or readmission for any reason between 31 and 60 days after the index exacerbation was recorded, as were complications, including all signs, symptoms, syndromes or diseases, which appeared or worsened during the 60-day observation period attributable to COPD or its treatment.
Recorded variables are: age, sex, BMI, medical history, clinical characteristics of the index exacerbation, and blood gas, biological, echocardiographic variables and the mortality at 6 years.
Overall, the severity of the index exacerbation was high as inferred from the baseline arterial pH (7.3 as a mean in two studies and 7.28 in one study) and from the predicted mortality derived from mortality prediction systems (SAPS and APACHE scores): between 15 and 24% in the three studies.
‡Drug used to define COPD exacerbation history before index.
Median time to randomisation from the time of discharge from hospital for the index exacerbation was 29 days, with no difference between groups.
When receiving an annual follow-up, exacerbation OR at index contact lowered for patients with lung disease (OR = 0.68), psychiatric disease (OR = 0.42), or ≥2 diseases (OR = 0.61).
