@misc{10481/104159,
year = {2025},
month = {4},
url = {https://hdl.handle.net/10481/104159},
abstract = {Introduction: Exacerbations of chronic obstructive pulmonary disease (COPD) significantly impact morbidity and
healthcare utilization. Identifying biomarkers predictive of exacerbation risk can optimize management strategies.
We evaluated the role of baseline fractional exhaled nitric oxide (FENO) as a predictor of moderate and
severe exacerbations over 90 days.
Methods: A prospective cohort study included COPD patients attending pulmonology clinics. Patients were
stratified based on baseline FENO levels: FENO <20 ppb and FENO ≥20 ppb. The primary outcome was time-tofirst
exacerbation, analysed using Kaplan-Meier survival curves and Cox proportional hazards models. Secondary
outcomes included differences in baseline characteristics and hazard ratios (HR) for severe exacerbations.
Results: A total of 322 patients were included (220 with FENO <20 ppb, 102 with FENO ≥20 ppb). Kaplan-Meier
analysis showed significantly shorter survival time without moderate/severe exacerbations in those with high
FENO. Cox regression demonstrated a 3.01-fold increased risk of moderate/severe exacerbations in high FENO
(HR: 3.01, 95 % CI: 1.83–4.93; p < 0.001). For severe exacerbations, those patients exhibited a non-significant
trend toward increased risk (HR: 2.49, 95 % CI: 0.91–6.86; p = 0.058).
Conclusion: Elevated FENO (≥20 ppb) is associated with increased short-term risk of moderate and severe COPD
exacerbations. These findings highlight FENO as a potential biomarker for early risk stratification and tailored
interventions in COPD patients},
publisher = {Elsevier},
title = {Short term exacerbation risk and exhaled nitric oxide in COPD},
doi = {10.1016/j.rmed.2025.108134},
author = {Romero Linares, Alejandro and Alvarez Muro, Lucía and Hammadi, A and Hoyas-Sánchez, Clara and Jiménez Antón, A and Almansa López, Angel and Casares Martín Moreno, Laura and Sánchez Álvarez, Esther and Murillo Rodriguez, A and Gómez Mora, M and Gómez-Pontes Cabrera, T and Romero Palacios, Pedro José and Alcázar Navarrete, Bernardino},
}