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. 2014 Dec 18;4(12):e006171. doi: 10.1136/bmjopen-2014-006171

Table 2 .

Factors associated with moderate-to-severe exacerbations during the 12-month follow-up period (three-category multilevel model)

Moderate-to-severe exacerbations during 12-month follow-up
≥2 vs none
1 vs none
≥2 vs 1
Factor OR 95% CI OR 95% CI OR 95% CI
COPD exacerbations, 12 months prior to observation period start
 No moderate event Reference
 1 moderate episode 3.31 3.12 to 3.51 1.89 1.79 to 1.99 1.76 1.65 to 1.87
 ≥2 moderate episodes 13.64 12.67 to 14.68 3.11 2.88 to 3.37 4.41 4.11 to 4.74
 No hospitalised episode Reference
 ≥1 hospitalised episode 2.13 1.95 to 2.31 1.49 1.38 to 1.61 1.44 1.32 to 1.57
Airflow limitation level nearest to observation period start
 Mild (FEV1 ≥80% predicted) Reference
 Moderate (≥50% FEV1 <80% predicted) 1.23 1.13 to 1.33 1.19 1.12 to 1.27 1.04 0.95 to 1.14
 Severe (≥30% FEV1 <50% predicted) 1.81 1.66 to 1.98 1.36 1.27 to 1.47 1.37 1.24 to 1.50
 Very severe (FEV1 >30% predicted) 2.37 2.08 to 2.70 1.59 1.41 to 1.79 1.56 1.37 to 1.78
MRC dyspnoea scale nearest to observation period start
 1 Reference
 2 1.39 1.28 to 1.51 1.16 1.09 to 1.23 1.16 1.06 to 1.27
 3 1.86 1.70 to 2.03 1.41 1.31 to 1.51 1.32 1.20 to 1.44
 4 2.74 2.49 to 3.03 1.55 1.43 to 1.69 1.74 1.57 to 1.93
 5 3.02 2.58 to 3.55 1.62 1.39 to 1.88 1.84 1.57 to 2.16
Comorbidities, history of medical diagnosis before observation period start (absence is referent category)
 Heart failure 1.2 1.08 to 1.32 1.1 1.00 to 1.20 1.11 1.00 to 1.23
 Myocardial infarction 1.13 1.03 to 1.24 1.15 1.06 to 1.24 0.96 0.87 to 1.05
 Rheumatological disease 1.12 1.01 to 1.24 1.1 1.01 to 1.21 1.04 0.94 to 1.16
 Renal disease 0.9 0.84 to 0.97 0.96 0.91 to 1.02 0.93 0.86 to 1.00
 Anxiety 1.16 1.08 to 1.25 1.14 1.08 to 1.22 1.02 0.95 to 1.09
 Depression 1.25 1.16 to 1.35 1.1 1.02 to 1.17 1.12 1.04 to 1.21
 Asthma 1.51 1.43 to 1.60 1.24 1.19 to 1.30 1.23 1.16 to 1.30
 Cancer 1.28 1.19 to 1.38 1.1 1.03 to 1.17 1.14 1.05 to 1.23
Number of contacts with GP, 12 months prior to observation period start
 Low: 0–5 Reference
 Medium: 6–9 1.02 0.95 to 1.10 1.07 1.00 to 1.13 0.99 0.91 to 1.07
 High: ≥10 1.24 1.16 to 1.32 1.18 1.12 to 1.24 1.08 1.01 to 1.16
Sex
 Female 1.19 1.13 to 1.26 1.12 1.07 to 1.17 1.07 1.01 to 1.14

Models further adjusted for age, smoking and BMI.

BMI, body mass index; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 s; GP, general practitioner; MRC, Medical Research Council.