Chronic obstructive pulmonary disease (COPD) is frequently complicated by factors such as perceived stress, which refers to how much stress a person feels they are experiencing in their life, based on their understanding of their situation

In this study, we used data from a study done among former smokers with COPD who live in low-income urban areas. We looked at the relationship between perceived stress and respiratory symptoms in this population and found that higher perceived stress is related to worse respiratory symptoms and worse quality of life. We also studied the relationship between perceived stress and disease processes that are known to play a role in COPD. We found that in mild-moderate COPD, perceived stress is associated with platelet activation, a process by which platelets—small cell fragments known for their role in clotting and the immune system—become activated. We also found that in individuals with severe COPD, perceived stress is associated with oxidative stress, which refers to the balance between oxidants and antioxidants in the body.

In summary, higher perceived stress is related to worse respiratory outcomes, and platelet activation and oxidative stress are processes in which perceived stress may play a role in COPD.

Emphysema, a type of lung damage, can be measured using computed tomography (CT) scans that determine how dense the lungs are. In people with alpha-1 antitrypsin deficiency (AATD), this measurement has been used to test whether treatments, such as augmentation therapy, are effective. However, we do not know how much lung density needs to change for the treatment to be meaningful for patients. This study aimed to identify the smallest meaningful change, known as the minimum clinically important difference, in lung density for people with AATD.

We used information from previous studies and a group of patients with AATD to calculate the minimum clinically important difference. We found that patients who lost more than -2.04 g/L of lung density had worse lung function and a higher risk of death.

These findings suggest that total lung density change could be a reliable measure for assessing how well treatments for emphysema in AATD are working. This could help improve how new therapies are tested and developed in the future.

Acute heart failure is a serious complication of chronic obstructive pulmonary disease (COPD), with some similarities between the two. Therefore, it is difficult to tell whether a patient with COPD has developed acute heart failure.

In this study, information from 3,730 patients was taken from a public database. The information from 2,611 patients was used to build a model to predict the risk of acute heart failure. The information or data of remaining patients was used to determine whether the model could successfully predict.

Our research indicated that the occurrence of acute heart failure was associated with 10 variables—observed or measured factors. Our model performs well in predicting the risk of acute heart failure.

Clinicians can use our model to evaluate patients with existing COPD and provide treatments to reduce the occurrence of acute heart failure.

Chronic bronchitis is often associated with chronic obstructive pulmonary disease (COPD). Chronic bronchitis is defined as having a cough and producing mucus for at least 3 months a year for 2 years in a row. Using this definition, we studied information from the Optum^® Electronic Health Records to identify patients with only chronic bronchitis, patients with only COPD, and those with both conditions. We compared patients’ characteristics, the timing of diagnosis, and their use of health care resources.

From January 2007 to September 2020, we examined records of 104,633,876 patients. Out of these, 628,545 had only chronic bronchitis, 129,084 had only COPD, and 77,749 had both conditions. Among those with both conditions, 80% were diagnosed with chronic bronchitis before being diagnosed with COPD, and 24% were diagnosed with COPD first. Compared to patients with only one condition, those with both chronic bronchitis and COPD used more health care resources over 5 years and had more additional health conditions.

These findings show the need for more focus on chronic bronchitis. Since patients often have chronic bronchitis before COPD and chronic bronchitis leads to high use of health care resources, better understanding and management of chronic bronchitis could help prevent progression to COPD and improve results for patients.

Pseudomonas aeruginosa is a type of bacteria found in patients with chronic respiratory diseases such as bronchiectasis. Its role in chronic obstructive pulmonary disease (COPD) is less well-known

We conducted this study to evaluate the role of Pseudomonas aeruginosa colonization –the presence of the bacteria without symptoms—in Chinese COPD patients. We included 327 COPD patients without co-existing asthma, bronchiectasis, and interstitial lung diseases in this study from 2 hospitals in Hong Kong and followed them for almost 2 years

We demonstrated that Pseudomonas aeruginosa colonization is associated with higher risks of moderate to severe acute exacerbation or flare-ups of COPD and pneumonia. The study suggested there is a negative impact of Pseudomonas aeruginosa colonization in patients with COPD. This matches findings about Pseudomonas aeruginosa in other chronic respiratory diseases.

Nontuberculous mycobacteria (NTM) lung disease is becoming more common, yet there is little information on how these patients fare in the hospital. We used a large, nationwide U.S. database to study adults admitted with a principal diagnosis of NTM lung infection. We wanted to see who stayed in the hospital longer and who needed to be discharged to a nursing home.

Our findings show that older patients, those with multiple comorbidities or additional health concerns, and individuals requiring more procedures during their stay tended to remain hospitalized longer. Older men were more frequently discharged to nursing homes. This highlights the importance of evaluating an individual’s ability to perform activities of daily living—their functional status—and planning for adequate support after discharge. Interestingly, patients with private insurance also had longer hospital stays, possibly due to delays or complications in arranging follow-up care.

These results point to key factors that influence hospital length of stay. Proactive discharge planning—especially for older male patients and those with complex medical needs—could shorten hospital stays and reduce costs for individuals with NTM lung disease.

Chronic obstructive pulmonary disease (COPD) is a serious, progressive respiratory condition. In this study, we identified people with COPD aged 40 and older from large databases of Medicare fee-for-service, Medicaid, and commercial health insurance claims and summarized their emergency department visits and hospital admissions for COPD. We wanted to understand how common COPD is across states and payer types and how often people with COPD visit emergency departments or get admitted to hospitals.

We found large differences in how common or frequent COPD is—its prevalence—and hospital admission rates across states and payer types. West Virginia had the highest COPD prevalence and Utah had the lowest. Most people with COPD were covered by Medicare fee-for-service plans. The District of Columbia had the highest hospital admission rate for COPD and Idaho had the lowest. Medicare fee-for-service patients had the most hospital admissions.

Understanding these differences helps health care providers, health insurers, government programs, and communities know where to focus their efforts, such as creating programs to help people in states with higher COPD rates and worse outcomes. These efforts could lead to improved care and health outcomes for people with COPD.

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. Sometimes an individual’s disease gets worse and they need to be hospitalized. Unfortunately, too many people then return to the hospital soon after being discharged. Predicting who may be rehospitalized could help hospitals learn how to reduce rehospitalizations.

We hoped to improve upon a tool we had already developed from a large database that used discharge billing codes (administrative data) since administrative data are not very accurate in identifying which patients were admitted for COPD. We developed a new tool that uses data from patients’ charts. We compared this new tool to the prediction tool developed from administrative data. We used information from the University of Chicago Medicine between 2008-2018.

Both tools had similar accuracy at predicting which COPD patients would later be readmitted to the hospital Our results suggest that, despite its limitations, administrative data may be useful for helping identify which patients may be readmitted and offer a less labor-intensive alternative to chart reviews.

Pulmonary rehabilitation is a supervised exercise and education program that helps people with chronic obstructive pulmonary disease (COPD) manage symptoms and improve their quality of life. Traditionally, pulmonary rehabilitation is done in person, but online or virtual programs have become more common. While virtual pulmonary rehabilitation offers benefits similar to traditional programs, there is limited data on which patient characteristics may be best suited for it.

In this study, we reviewed information from 167 COPD patients who participated in a virtual pulmonary rehabilitation program. We divided them into 2 groups: those who use oxygen and those who do not. We then compared their attendance, safety, and improvements in symptoms, mood, and exercise capacity.

Both groups attended most sessions (88% attendance) with very few safety concerns (only 2 minor events). They also showed significant improvements in breathing, depression symptoms, and exercise capacity (the amount of physical activity their body could handle). Importantly, patients who used oxygen therapy improved as much as those who did not use oxygen.

These findings show that virtual pulmonary rehabilitation is a safe and effective option for COPD patients—including those on oxygen, who have not been specifically studied before. This can help doctors and patients make more personalized treatment decisions.

Electronic health records are a valuable resource for researchers to gather information on conditions such as chronic obstructive pulmonary disease (COPD) in real-world settings. Identifying COPD flare-ups or acute exacerbations in electronic records is important to understand how these events impact people's lives and the impact they have on health care resources.

We aimed to review all the studies that have validated (checked for accuracy ) recordings of acute exacerbations of COPD in electronic health records. We searched 2 medical databases (Medline and Embase) for studies that met our criteria or guidelines. We then reviewed which processes had been used in the studies to identify acute COPD exacerbations and whether these exacerbations were accurately recorded.

Twelve studies met our criteria and we found that although acute exacerbations of COPD can be accurately identified in electronic records using processes or algorithms, these algorithms vary widely. Also, there is no clear agreement on which provides the most accurate definitions of an acute COPD exacerbation.

Our review is important to guide researchers on which algorithms are being used to identify acute exacerbations of COPD and where further research is needed to determine which definitions are the most accurate.