Risk factors of acute exacerbation and disease progression in young patients with COPD

Objective We aimed to elucidate the clinical factors associated with acute exacerbation and disease progression in young patients with chronic obstructive pulmonary disease (COPD). Methods This retrospective longitudinal observational study included patients with COPD aged between 20 and 50 years with post-bronchodilator forced expiratory volume in one second (FEV 1 )/forced vital capacity (FVC)300/µL (aHR=1.469, 95% CI=1.038–2.081) and low FEV 1 (%) (aHR=0.979, 95% CI=0.970–0.987). A history of asthma, sputum, blood eosinophil count >300/µL, low FEV 1 (%) and low diffusing capacity of the lung for carbon monoxide (DL CO ) (%) were identified as clinical factors associated with the early initiation of regular inhalation therapy. The risk factors associated with worsened FEV 1 decline were increasing age, female sex, history of pulmonary tuberculosis, sputum, low FEV 1 (%) and low DL CO (%). Conclusions In young COPD patients, specific high-risk features of acute exacerbation and disease progression need to be identified, including a history of previous respiratory diseases, current respiratory symptoms, blood eosinophil counts, and structural or functional pulmonary impairment.