COMPREHENSIVE ASSESSMENT OF FACTORS ASSOCIATED WITH THE PROGRESSION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Introduction. The significant clinical heterogeneity of chronic obstructive pulmonary disease (COPD) manifests itself in various phenotypes, rates of progression, and responses to treatment. Since the clinical course of COPD is multifactorial, it is necessary to consider not only spirometry parameters but also clinical, laboratory, and comorbid factors when predicting disease progression. Aim - to identify patterns of changes in pulmonary function and blood oxygenation parameters in patients with COPD depending on disease stage and clinical and epidemiological characteristics. Materials and Methods. The study included 100 patients with COPD who were receiving inpatient or outpatient care at the Ternopil Regional Clinical Hospital. The diagnosis of COPD was established in accordance with the recommendations of the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2024) based on clinical manifestations, medical history, and spirometry results. All patients were divided into four groups based on the severity of bronchial obstruction according to the GOLD classification: Group 1—Stage I (GOLD 1)—29 patients; Group 2—Stage II (GOLD 2)—39 patients; Group 3 – Stage III (GOLD 3) – 24 patients; Group 4 – Stage IV (GOLD 4) – 8 patients. The study analyzed the demographic, clinical, and anthropometric characteristics of the patients. Statistical analysis was performed using Statistica 13.0. Results. A decrease in the FEV₁ value was observed, from 90.66±5.56% in Stage I to 23.13±4.26% in Stage IV COPD (p<0.001), while the SpO₂ level decreased from 96.34 ± 1.61% to 88.00 ± 2.45% (p < 0.001). At the same time, disease duration and the frequency of exacerbations tended to increase with advancing COPD stage; however, no statistically significant differences were found between the groups (p > 0.05). COPD severity is significantly associated with increased smoking history (r = 0.53; p < 0.001) and a decrease in pulmonary function parameters (FEV₁: r = −0.95; p < 0.001) and blood oxygenation (SpO₂: r = −0.71; p < 0.001). Tobacco exposure correlates negatively with FEV₁ (r = −0.54; p < 0.001) and SpO₂ (r = −0.44; p < 0.001), whereas a strong positive correlation was found between FEV₁ and SpO₂ (r = 0.67; p < 0.001). Conclusions. The most informative approach in COPD is a comprehensive evaluation of patients that takes into account functional parameters (FEV₁, SpO₂), tobacco exposure, laboratory markers of systemic inflammation, and other clinical parameters, which allows for a more accurate assessment of COPD severity, prediction of disease progression, and optimization of treatment strategies.