@article {1433696,
	title = {Prediction of acute respiratory disease in current and former smokers with and without COPD},
	journal = {Chest},
	volume = {146},
	number = {4},
	year = {2014},
	month = {2014 Oct},
	pages = {941-950},
	abstract = {BACKGROUND: The risk factors for acute episodes of respiratory disease in current and former smokers who do not have COPD are unknown.

METHODS: Eight thousand two hundred forty-six non-Hispanic white and black current and former smokers in the Genetic Epidemiology of COPD (COPDGene) cohort had longitudinal follow-up (LFU) every 6 months to determine acute respiratory episodes requiring antibiotics or systemic corticosteroids, an ED visit, or hospitalization. Negative binomial regression was used to determine the factors associated with acute respiratory episodes. A Cox proportional hazards model was used to determine adjusted hazard ratios (HRs) for time to first episode and an acute episode of respiratory disease risk score.

RESULTS: At enrollment, 4,442 subjects did not have COPD, 658 had mild COPD, and 3,146 had moderate or worse COPD. Nine thousand three hundred three acute episodes of respiratory disease and 2,707 hospitalizations were reported in LFU (3,044 acute episodes of respiratory disease and 827 hospitalizations in those without COPD). Major predictors included acute episodes of respiratory disease in year prior to enrollment (HR, 1.20; 95\% CI, 1.15-1.24 per exacerbation), airflow obstruction (HR, 0.94; 95\% CI, 0.91-0.96 per 10\% change in \% predicted FEV1), and poor health-related quality of life (HR, 1.07; 95\% CI, 1.06-1.08 for each 4-unit increase in St. George{\textquoteright}s Respiratory Questionnaire score). Risks were similar for those with and without COPD.

CONCLUSIONS: Although acute episode of respiratory disease rates are higher in subjects with COPD, risk factors are similar, and at a population level, there are more episodes in smokers without COPD.},
	keywords = {Acute Disease, Aged, Female, Follow-Up Studies, Hospitalization, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Proportional Hazards Models, Pulmonary Disease, Chronic Obstructive, Quality of Life, Respiratory Tract Diseases, Risk Factors, Smoking, United States},
	issn = {1931-3543},
	doi = {10.1378/chest.13-2946},
	author = {Bowler, Russell P and Kim, Victor and Regan, Elizabeth and Williams, Andr{\'e} A A and Santorico, Stephanie A and Make, Barry J and Lynch, David A and Hokanson, John E and Washko, George R and Bercz, Peter and Soler, Xavier and Marchetti, Nathaniel and Criner, Gerard J and Ramsdell, Joe and Han, MeiLan K and Demeo, Dawn and Anzueto, Antonio and Comellas, Alejandro and Crapo, James D and Dransfield, Mark and Wells, J Michael and Hersh, Craig P and MacIntyre, Neil and Martinez, Fernando and Nath, Hrudaya P and Niewoehner, Dennis and Sciurba, Frank and Sharafkhaneh, Amir and Silverman, Edwin K and van Beek, Edwin J R and Wilson, Carla and Wendt, Christine and Wise, Robert A}
}