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Expiratory central airway collapse facilitates poor respiratory quality of life

Patients who are current and former smokers with expiratory central airway collapse have significantly worse respiratory quality of life compared with smokers who do not have the condition, according to recent research.

“In a cross-sectional analysis of current and former smokers, the presence of [expiratory central airway collapse (ECAC)] was associated with worse respiratory quality of life,” Surya P. Bhatt, MD, of the division of pulmonary and allergy and critical care medicine, at University of Alabama at Birmingham, and colleagues wrote. “Further studies are needed to assess long-term associations with clinical outcomes.”

Bhatt and colleagues evaluated 8,820 patients (mean age, 59.7 years; 56.7% men; 51.7% active smokers) with and without COPD between 2008 and 2011, with longitudinal follow up into 2014, according to the abstract. Five percent (n = 443) of the patients had ECAC.

Patients with ECAC had poorer St. George’s Respiratory Questionnaire scores (30.9 units) compared with patients who did not have ECAC (26.5 units), with an absolute difference of 4.4 units (95% CI, 2.2-6.6), according to the abstract. Further, patients with ECAC also showed poorer modified Medical Research Council scale scores (median 2 units vs. 1 unit; P < .001) compared with patients who did not have ECAC.

Researchers observed no significant differences after adjusting for age, sex, BMI, ethnicity, emphysema, smoking history as measured in pack-years and forced expiratory volume in 1 second in the 6-minute walk test. At a median 4.3-year follow-up, Bhatt and colleagues noted an increased number of exacerbations in the ECAC group at 58 events per 100 person-years vs. 35 events per 100 person-years in the non-ECAC group (incident rate ratio [IRR] = 1.49; 95% CI, 1.29-1.72) as well as severe exacerbations resulting in hospitalization at 17 events per 100 person-years compared with 10 events per 100 person-years in the non-ECAC group (IRR = 1.83; 95% CI, 1.51-2.21), according to the abstract. – by Jeff Craven

Disclosure: Bhatt reports funding from the American Heart Association and NIH KL2 Scholarship. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.