Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?

Table 3 Risk of severe acute exacerbation according to different BDR criteria

	cOR (95% CI)	p-value	aOR^a (95% CI)	p-value	AIC
All participants (n = 854)
BDR >12% and 200 ml (FEV1) (GOLD)	0.30 (0.13–0.71)	0.01	0.37 (0.15–0.91)	0.03	471.470
BDR ≥12% and 200 ml (FEV1 or FVC) (ATS)	0.51 (0.28–0.90)	0.02	0.51 (0.28–0.96)	0.04	472.485
BDR ≥15% (FEV1) (ACCP)	0.73 (0.40–1.32)	0.29	0.53 (0.28–1.02)	0.06	473.416
BDR >8% (FEV1)	1.04 (0.66–1.64)	0.87	0.94 (0.57–1.55)	0.80	477.245
BDR ≥15% and 400 ml (FEV1) (Spanish ACOS)	0.32 (0.04–2.39)	0.27	0.51 (0.06–4.07)	0.53	476.726
BDR >12% and 400 ml (FEV1) (ACOS GINA)	0.32 (0.04–2.39)	0.27	0.51 (0.06–4.07)	0.53	476.726
Post FEV1% - pre FEV1 % ≥ 10% (ERS)	0.53 (0.24–1.18)	0.12	0.78 (0.33–1.84)	0.58	476.984
Participants with smoking history ≥ 10PY (a sensitivity analysis, n = 728)
BDR >12% and 200 ml (FEV1) (GOLD)	0.29 (0.11–0.72)	0.01	0.36 (0.14–0.95)	0.04	399.119
BDR ≥12% and 200 ml (FEV1 or FVC) (ATS)	0.57 (0.31–1.05)	0.07	0.60 (0.31–1.15)	0.12	401.829
BDR ≥15% (FEV1) (ACCP)	0.70 (0.37–1.35)	0.29	0.56 (0.28–1.12)	0.10	401.406
BDR >8% (FEV1)	1.02 (0.61–1.69)	0.95	0.94 (0.54–1.64)	0.84	404.324
BDR ≥15% and 400 ml (FEV1) (Spanish ACOS)	0.35 (0.05–2.60)	0.30	0.61 (0.08–4.85)	0.64	404.022
BDR >12% and 400 ml (FEV1) (ACOS GINA)	0.35 (0.05–2.60)	0.30	0.61 (0.08–4.85)	0.64	404.022
Post FEV1% - pre FEV1 % ≥ 10% (ERS)	0.53 (0.22–1.26)	0.15	0.89 (0.35–2.24)	0.80	404.301

BDR bronchodilator reversibility, PY pack-year, cOR crude odds ratios, aOR adjusted ORs, AIC Akaike Information Criterion
^aAdjusted by BMI, symptom score of mMRC ≥2 vs < 2, comorbidity of diabetes mellitus, initial FEV1% ≥50 vs < 50, medication possession ratio of inhaled corticosteroid/long-acting beta-agonist, and severe acute exacerbation within 1 year before enrollment

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