Factors Affecting Survival in Severe and Very Severe COPD after Admission in ICUs of Tertiary Care Centers of India (FAST COPD): Study Protocol for a Multicentric Cohort Study.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. However, there is a lack of comprehensive data from low- and middle-income countries (LMICs) regarding factors influencing COPD outcomes, particularly in regions where biomass exposure is prevalent. Objective: The Factors Affecting Survival in Severe and Very Severe COPD Patients Admitted to Tertiary Centers of India (FAST) study aims to address this gap by evaluating factors impacting survival and exacerbation rates among COPD patients in LMICs like India, with a specific focus on biomass exposure, clinical phenotypes, and nutritional status in patients admitted to the Intensive Care Unit (ICU). Methods: The FAST study is an observational cohort study conducted in university teaching hospitals across India. The study aims to enroll 1000 COPD patients admitted to the ICU meeting specific inclusion criteria, with follow-up assessments conducted every 6 months over a 2-year period. Data collection includes demographic information, clinical manifestations, laboratory investigations, pulmonary function tests, medications, nutritional status, mental health, and health-related quality of life. Adjudication of exacerbations and mortality will also be undertaken. The FAST study seeks to provide crucial insights into COPD outcomes in LMICs, informing more precise management strategies and mitigating the burden of COPD in these settings. By evaluating factors such as biomass exposure, clinical phenotypes, and nutritional status, the study aims to address key knowledge gaps in COPD research. How to cite this article: Arunachala S, Devapal S, Swamy DSN, Greeshma MV, Ul Hussain I, Siddaiah JB, et al. Factors Affecting Survival in Severe and Very Severe COPD after Admission in ICUs of Tertiary Care Centers of India (FAST COPD): Study Protocol for a Multicentric Cohort Study. Indian J Crit Care Med 2024;28(6):552-560.

The Natural History of Severe Chronic Obstructive Pulmonary Disease: The SPOCCAT Study Protocol.

Introduction: Patients with severe chronic obstructive pulmonary disease (COPD) are often underrepresented in cohorts, creating uncertainty about the natural history and prognostic factors of this subgroup. Our goal was to describe the SPOCCAT (Severe COPD: Prospective Observational study of COPD in Catalonia) study protocol. Material and methods: SPOCCAT is a non-interventional, multicenter, prospective cohort study of patients with severe COPD (FEV1% predicted < 50%). The study aims to: (1) establish a five-year prospective cohort; (2) identify demographic and clinical characteristics; (3) describe treatment patterns; (4) better understand the natural history of severe COPD, including lung function decline, exacerbation rates, and mortality; and (5) identify prognostic factors for poor outcomes.Recruitment began in January 2024, and the cohort will be followed for a minimum of five years (or until death or lung transplant) with follow-up visits every 12 months. Baseline data include demographics, laboratory analyses, comorbidities, lung function, respiratory symptoms, respiratory disease exacerbations and etiology, quality of life, physical activity, chest computed tomography, and treatment. Annual follow-up visits will assess changes in treatment, exacerbation frequency and severity, microbiological outcomes, complementary tests, and mortality. Participation requires written informed consent from all patients, with data collected in an anonymized electronic Case Report Form. Results: The results of the SPOCCAT study will provide relevant information about the characteristics, treatment, and prognostic factors of severe COPD. Conclusions: SPOCCAT has the potential to enhance understanding of severe COPD, exploring innovative aspects and establishing a robust research framework for future COPD-related projects.

Introducción: Los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) grave a menudo están infrarepresentados en las cohortes, lo que genera incertidumbre sobre la historia natural y los factores pronósticos de este subgrupo. Nuestro objetivo fue describir el protocolo del estudio de EPOC grave: estudio observacional prospectivo de la EPOC en Cataluña (SPOCCAT). Material y método: El SPOCCAT es un estudio de cohorte prospectivo, multicéntrico y no intervencionista de pacientes con EPOC grave (volumen espiratorio forzado en un segundo [FEV1] % previsto < 50%). El estudio tiene como objetivo: 1) establecer una cohorte prospectiva de cinco años, 2) identificar características demográficas y clínicas, 3) describir patrones de tratamiento, 4) comprender mejor la historia natural de la EPOC grave, incluida la disminución de la función pulmonar, las tasas de exacerbación y la mortalidad, y 5) identificar factores de pronóstico de malos resultados. El reclutamiento comenzó en enero de 2024 y se seguirá a la cohorte durante un mínimo de cinco años (o hasta la muerte o el trasplante de pulmón) con visitas de seguimiento cada 12 meses. Los datos basales incluyen datos demográficos, análisis de laboratorio, comorbilidades, función pulmonar, síntomas respiratorios, exacerbaciones y etiología de enfermedades respiratorias, calidad de vida, actividad física, tomografía computarizada de tórax y tratamiento. Las visitas de seguimiento anuales evaluarán cambios en el tratamiento, frecuencia y gravedad de las exacerbaciones, resultados microbiológicos, pruebas complementarias y mortalidad. La participación requiere el consentimiento informado por escrito de todos los pacientes, con datos anonimizados recopilados en un cuaderno de recogida de datos electrónico. Resultados: Los resultados del estudio SPOCCAT aportarán información relevante sobre las características, el tratamiento y los factores pronósticos de la EPOC grave. Conclusiones: El estudio SPOCCAT tiene el potencial de mejorar la comprensión de la EPOC grave, explorando aspectos innovadores y estableciendo un marco de investigación sólido para futuros proyectos relacionados con la EPOC.

Study on the efficacy and quality of life of tiotropium combined with sulpiride in elderly patients with moderate to severe COPD / 中国生化药物杂志

Objective To observe the effect of tiotropium combined Seretide in the treatment of elderly patients with moderate to severe COPD clinical curative effect and the influence on the quality of life of patients.Methods114 cases of moderate or severe COPD in our hospital from January 2014 to January 2016,were randomly divided into observation group and control group, 57 cases in each group.The control group was treated with Seretide treatment, the observation group were treated by tiotropium combined with Seretide treatment, compared two groups of patients with curative effect and quality of life.ResultsBefore treatment, there were no significant differences in lung function index, MRC score, 6MWT and WHOQOL-100 scores between the two groups;After treatment, FEV1/FVC and FEV1% in the observation group were significantly higher than in the control group, and the difference was statistically significant (P<0.05);the dyspnea severity score (MRC) and six minute walk test (6MWT) in the observation group were significantly better than those in the control group, and the differences were statistically significant (P<0.05);the quality of life score (WHOQOL-100) in the observation group was significantly higher than in the control group, the difference was statistically significant (P<0.05).ConclusionTiotropium bromide combined with nimesulide in the treatment of elderly patients with moderate or severe COPD is effective, and can effectively improve the level of pulmonary function, improve the quality of life of patients.

Impacts of abnormal lipid metabolism on prognosis and quality of life in patients with severe COPD / 实用医学杂志

Objective To investigate the influence of abnormal lipid metabolism on prognosis and quality of life in patients with severe COPD. Methods 134 patients with severe COPD in our hospital from September 2013 to January 2015 were selected as research objects, and their blood lipid levels were detected. The patients were divided into the normal group (n=61) and the low level group (n=73) according to the test results of lipid levels. 1-year mortality rate was statistically analyzed in both groups , and the WHOQOL-BREF health survey profile was applied to assess quality of life before and after treatment. Results 1-year survival rate in the normal group was 90.16%(55/61), which was higher than 73.97%(54/73) in the low level group (χ2=5.741, P=0.017). As compared with the normal group, the scores on physiological function, environment, social relationship, mental state, spirit / religious / belief, and total quality of lifewere markedly lower in the low level group after treatment (P < 0.05). The correlation analysis showed that plasma levels of TC, TG, and HDL-C were negatively correlated with 1-year mortality rate in patients with severe COPD (P < 0.05) but positively related with all dimensions in quality of life; plasma HDL-C level was positively related with 1-year mortality rate (P < 0.05), but negatively related with all dimensions in quality of life in patients with severe COPD (P < 0.05). Conclusions For patients with severe COPD, abnormal lipid metabolism is closely related with prognosis and quality of life. We should pay attention to nutritional support and control of abnormal lipid metabolism in those patients , leading to improvement of prognosis and quality of life.