title: Self-reported alcohol intake and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study.
abstract: OBJECTIVE
  To evaluate the relationship between alcohol consumption and the risk of acute exacerbation of COPD (AECOPD).
  
  
  METHODS
  We conducted a secondary analysis of data previously collected in a large, multicenter trial of daily azithromycin in COPD. To analyze the relationship between amount of baseline self-reported alcohol consumption in the past 12 months and subsequent AECOPD, we categorized the subjects as minimal (<1 drink/month), light-to-moderate (1-60 drinks/month), or heavy alcohol users (>60 drinks/month). The primary outcome was time to first AECOPD and the secondary outcome was AECOPD rate during the 1-year study period.
  
  
  RESULTS
  Of the 1,142 enrolled participants, 1,082 completed baseline alcohol questionnaires and were included in this analysis. Six hundred and forty-five participants reported minimal alcohol intake, 363 reported light-to-moderate intake, and 74 reported heavy intake. There were no statistically significant differences in median time to first AECOPD among minimal (195 days), light-to-moderate (241 days), and heavy drinkers (288 days) (P=0.11). The mean crude rate of AECOPD did not significantly differ between minimal (1.62 events per year) and light-to-moderate (1.44 events per year) (P=0.095), or heavy drinkers (1.68 events per year) (P=0.796). There were no significant differences in hazard ratios for AECOPD after adjustment for multiple covariates.
  
  
  CONCLUSIONS
  Among persons with COPD at high risk of exacerbation, we found no significant relationship between self-reported baseline alcohol intake and subsequent exacerbations. The number of patients reporting heavy alcohol intake was small and further study is needed to determine the effect of heavy alcohol intake on AECOPD risk.
authors.affiliation: Pulmonary Section, Minneapolis Veterans Affairs Health Care System, University of Minnesota, Minneapolis, MN, USA ; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Wetherbee
authors.affiliation: Pulmonary Section, Minneapolis Veterans Affairs Health Care System, University of Minnesota, Minneapolis, MN, USA ; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Dennis E
authors.initials: DE
authors.lastname: Niewoehner
authors.affiliation: Pulmonary, Critical Care, Sleep and Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Sisson
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Lindberg
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Connett
authors.affiliation: Pulmonary Section, Minneapolis Veterans Affairs Health Care System, University of Minnesota, Minneapolis, MN, USA ; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Ken M
authors.initials: KM
authors.lastname: Kunisaki
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin
keywords: alcohol; alcoholism; chronic obstructive; ethanol; pulmonary disease