{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T01:34:25Z","timestamp":1774488865067,"version":"3.50.1"},"reference-count":123,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T00:00:00Z","timestamp":1667692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Global Infectious Disease Research Training program","award":["D43TW010332-01A1 to PAM"],"award-info":[{"award-number":["D43TW010332-01A1 to PAM"]}]},{"name":"Global Infectious Disease Research Training program","award":["IA\/TSG\/19\/1\/600026 to PAM"],"award-info":[{"award-number":["IA\/TSG\/19\/1\/600026 to PAM"]}]},{"name":"Global Infectious Disease Research Training program","award":["S.U.: 20210548"],"award-info":[{"award-number":["S.U.: 20210548"]}]},{"name":"Global Infectious Disease Research Training program","award":["K.G.: 20200776"],"award-info":[{"award-number":["K.G.: 20200776"]}]},{"name":"Wellcome Trust DBT India Alliance","award":["D43TW010332-01A1 to PAM"],"award-info":[{"award-number":["D43TW010332-01A1 to PAM"]}]},{"name":"Wellcome Trust DBT India Alliance","award":["IA\/TSG\/19\/1\/600026 to PAM"],"award-info":[{"award-number":["IA\/TSG\/19\/1\/600026 to PAM"]}]},{"name":"Wellcome Trust DBT India Alliance","award":["S.U.: 20210548"],"award-info":[{"award-number":["S.U.: 20210548"]}]},{"name":"Wellcome Trust DBT India Alliance","award":["K.G.: 20200776"],"award-info":[{"award-number":["K.G.: 20200776"]}]},{"name":"Swedish Heart-Lung Foundation","award":["D43TW010332-01A1 to PAM"],"award-info":[{"award-number":["D43TW010332-01A1 to PAM"]}]},{"name":"Swedish Heart-Lung Foundation","award":["IA\/TSG\/19\/1\/600026 to PAM"],"award-info":[{"award-number":["IA\/TSG\/19\/1\/600026 to PAM"]}]},{"name":"Swedish Heart-Lung Foundation","award":["S.U.: 20210548"],"award-info":[{"award-number":["S.U.: 20210548"]}]},{"name":"Swedish Heart-Lung Foundation","award":["K.G.: 20200776"],"award-info":[{"award-number":["K.G.: 20200776"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Acute exacerbations of COPD (AECOPD) are clinically significant events having therapeutic and prognostic consequences. However, there is a lot of variation in its clinical manifestations described by phenotypes. The phenotypes of AECOPD were categorized in this study based on pathology and exposure. In our cross-sectional study, conducted between 1 January 2016 to 31 December 2020, the patients were categorized into six groups based on pathology: non-bacterial and non-eosinophilic; bacterial; eosinophilic; bacterial infection with eosinophilia; pneumonia; and bronchiectasis. Further, four groups were classified based on exposure to tobacco smoke (TS), biomass smoke (BMS), both, or no exposure. Cox proportional-hazards regression analyses were performed to assess hazard ratios, and Kaplan\u2013Meier analysis was performed to assess survival, which was then compared using the log-rank test. The odds ratio (OR) and independent predictors of ward admission type and length of hospital stay were assessed using binomial logistic regression analyses. Of the 2236 subjects, 2194 were selected. The median age of the cohort was 67.0 (60.0 to 74.0) and 75.2% were males. Mortality rates were higher in females than in males (6.2% vs. 2.3%). AECOPD-B (bacterial infection) subjects [HR 95% CI 6.42 (3.06\u201313.46)], followed by AECOPD-P (pneumonia) subjects [HR (95% CI: 4.33 (2.01\u20139.30)], were at higher mortality risk and had a more extended hospital stay (6.0 (4.0 to 9.5) days; 6.0 (4.0 to 10.0). Subjects with TS and BMS-AECOPD [HR 95% CI 7.24 (1.53\u201334.29)], followed by BMS-AECOPD [HR 95% CI 5.28 (2.46\u201311.35)], had higher mortality risk. Different phenotypes have different impacts on AECOPD clinical outcomes. A better understanding of AECOPD phenotypes could contribute to developing an algorithm for the precise management of different phenotypes.<\/jats:p>","DOI":"10.3390\/toxics10110667","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T03:10:46Z","timestamp":1667790646000},"page":"667","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of Acute Exacerbation and Its Phenotypes on the Clinical Outcomes of Chronic Obstructive Pulmonary Disease in Hospitalized Patients: A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8470-3114","authenticated-orcid":false,"given":"Mohammed","family":"Kaleem Ullah","sequence":"first","affiliation":[{"name":"Centre for Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSSAHER, Mysore 570015, Karnataka, India"},{"name":"Global Infectious Diseases Fellow, Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7270-0247","authenticated-orcid":false,"given":"Ashwaghosha","family":"Parthasarathi","sequence":"additional","affiliation":[{"name":"Allergy, Asthma, and Chest Centre, Krishnamurthypuram, Mysore 570004, Karnataka, India"},{"name":"RUTGERS Centre for Pharmacoepidemiology and Treatment Science, New Brunswick, NJ 08901-1293, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayaraj","family":"Biligere Siddaiah","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore 570015, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant","family":"Vishwanath","sequence":"additional","affiliation":[{"name":"Centre for Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSSAHER, Mysore 570015, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swapna","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-8154","authenticated-orcid":false,"given":"Koustav","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-5945","authenticated-orcid":false,"given":"Padukudru","family":"Anand Mahesh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore 570015, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1164\/ajrccm.163.5.2101039","article-title":"GOLD Scientific Committee Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: NHLBI\/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary","volume":"163","author":"Pauwels","year":"2001","journal-title":"Am. 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