PP20 DISEASE BURDEN IN COPD - SEVERITY, EXACERBATION RATE & MORTALITY AMONG COPD PATIENTS IN MALAYSIA: EXACOS-MY STUDY

Aisya Natasya Musa1,2, Ahmad Izuanuddin Ismail1,2, Syazatul Syakirin Sirol Aflah3, Wong Chee Kuan4
1Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia.
2Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), 42300 Bandar Puncak Alam, Selangor, Malaysia.
3Institut Perubatan Respiratori, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
4University Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia.

Introduction:

Frequent exacerbations in chronic obstructive pulmonary disease (COPD) patients cause a rapid decline in lung function, with even a single moderate episode increasing the risk of future exacerbations and mortality.

Objectives:

We aim to explore the association between disease severity (GOLD grades), rate of exacerbation and mortality. 

Methodology:

The observational, cross-sectional EXACerbations and their OutcomeS among COPD patients in MalaYsia (EXACOS-MY) study was conducted in three tertiary hospitals in Malaysia from January 2018 to December 2022. Patients with at least one severe exacerbation were examined for three years according to their COPD GOLD grade at diagnosis.   

Results:

Among the 471 patients included, most (94.3%) were males, with a mean age of 72.4 years. Ex-smokers comprised 81.2% of the patients, with an average smoking history of 17.7 years. Approximately half of the patients with COPD GOLD 3 (34.8%) and GOLD 4 (13%), with a large majority of 84.7% belonging to COPD pharmacological treatment group of Group E. The overall rate of exacerbation was 1.06/year/patient. Over three years, 66.2% of patients experienced more than two exacerbations, with 19.5% having more than four exacerbations. Death occurred in 85 patients (18%), with 52.9% of them classified as GOLD 3 and GOLD 4.

Conclusion:

A more severe COPD represents a higher disease burden with frequent exacerbations, which results in a greater mortality rate among COPD patients. These findings emphasize the importance of managing exacerbation rates to improve patient survival.