TY - JOUR
T1 - Multidimensional prognostic risk stratification of COPD exacerbations
T2 - the baseline, acuity, and trigger (BAt) model
AU - Aung, Hnin W.W.
AU - Vermeersch, Kristina
AU - McAuley, Hamish J.C.
AU - Ramakrishnan, Sanjay
AU - Abdo, Mustafa
AU - Beersaerts, Amber
AU - Cass, Steven P.
AU - Smallcombe, Nicola
AU - Gyselinck, Iwein
AU - Pott, Hendrik
AU - Ward, Tom J.C.
AU - Wright, Adam K.A.
AU - Brightling, Christopher E.
AU - Burgel, Pierre Régis
AU - Contoli, Marco
AU - Franssen, Frits M.E.
AU - Huerta, Arturo
AU - Quint, Jennifer K.
AU - Schmeck, Bernd
AU - Vanfleteren, Lowie E.G.W.
AU - Waschki, Benjamin
AU - Watz, Henrik
AU - Bafadhel, Mona
AU - Janssens, Wim
AU - Greening, Neil J.
AU - CICERO Consortium
N1 - Funding Information:
We thank all members of the CICERO consortium and patient and public involvement group (NIHR Leicester Biomedical Research Centre) for their invaluable contributions to the discussions and workshops that shaped this manuscript. This research is supported by the NIHR Leicester Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2025 Elsevier Ltd
PY - 2026/2
Y1 - 2026/2
N2 - Exacerbations punctuate the natural course of chronic obstructive pulmonary disease (COPD), posing a substantial burden on patients and health-care systems. Understanding the severity of an acute exacerbation of COPD (AECOPD) is crucial for stratifying mortality risk and guiding treatment decisions. Currently, the severity of an AECOPD is primarily graded on outcomes of health-care use. Given the complex heterogeneity in pathogenesis, clinical presentation, post-event trajectory, and patient perspectives, this approach does not adequately address the causes and extent of clinical deterioration or consider an individual's baseline status, upon which implementation of treatment and prevention of future exacerbations rely. We have conceptualised a multidimensional model to stratify the severity and prognostic risk of an AECOPD, incorporating three distinct domains: baseline functional status (B), the intensity of the event (acuity; A), and the causal trigger (t). The BAt classification for AECOPD could allow for more individualised prognostic and therapeutic implications. The validation process for this model is underway, with preliminary findings supporting its feasibility.
AB - Exacerbations punctuate the natural course of chronic obstructive pulmonary disease (COPD), posing a substantial burden on patients and health-care systems. Understanding the severity of an acute exacerbation of COPD (AECOPD) is crucial for stratifying mortality risk and guiding treatment decisions. Currently, the severity of an AECOPD is primarily graded on outcomes of health-care use. Given the complex heterogeneity in pathogenesis, clinical presentation, post-event trajectory, and patient perspectives, this approach does not adequately address the causes and extent of clinical deterioration or consider an individual's baseline status, upon which implementation of treatment and prevention of future exacerbations rely. We have conceptualised a multidimensional model to stratify the severity and prognostic risk of an AECOPD, incorporating three distinct domains: baseline functional status (B), the intensity of the event (acuity; A), and the causal trigger (t). The BAt classification for AECOPD could allow for more individualised prognostic and therapeutic implications. The validation process for this model is underway, with preliminary findings supporting its feasibility.
U2 - 10.1016/S2213-2600(25)00362-5
DO - 10.1016/S2213-2600(25)00362-5
M3 - (Systematic) Review article
SN - 2213-2600
VL - 14
SP - 174
EP - 186
JO - The Lancet Respiratory medicine
JF - The Lancet Respiratory medicine
IS - 2
ER -