2010 137 (5): 1091‐1097.The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised many questions about the management of patients with chronic obstructive pulmonary disease (COPD) and whether modifications of their therapy are required. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Patient’s perception of exacerbations of COPD: the PERCEIVE study. Miravitlles M, Anzueto A, Legnani D, et al. Acute Exacerbations and Lung Function Loss in Smokers With and Without Chronic Obstructive Pulmonary Disease.
Dransfield MT Kunisaki KM, Strand MJ, et al. Effect of a single exacerbation on decline in lung function in COPD. Early Therapy Improves Outcomes of Exacerbations of Chronic Obstructive Pulmonary Disease. Wilkinson TMA, Donaldson GC, Hurst JR, et al. Negative impacts of unreported COPD exacerbations on health-related quality of life at 1 year. Underreporting Exacerbation of Chronic Obstructive Pulmonary Disease in a Longitudinal Cohort. Langsetmo L, Platt RW, Ernst P, Bourbeau J. Performance of the EXAcerbations of Chronic Pulmonary Disease Tool Patient-Reported Outcome Measure in Three Clinical Trials of Chronic Obstructive Pulmonary Disease. et al. Spirometric changes during exacerbations of COPD: a post hoc analysis of the WISDOM trial. One-year and long-term mortality in patients hospitalized for chronic obstructive pulmonary disease.
García-Sanz MT, Cánive-Gómez JC, Senín-Rial L, et al. Risk Trajectories of Readmission and Death in the First Year After Hospitalization for Chronic Obstructive Pulmonary Disease Am J Respir Crit Care Med. Lindenauer PK, Dharmarajan K, Qin L, et al. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. In-Hospital and One-Year Mortality and Their Predictors in Patients Hospitalized for First-Ever Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Population-Based Study.
COPD exacerbations significantly impact quality of life as measured by SGRQ-C total score: results from the FLAME study. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020. 1Īs we continue the fight against COVID-19, the global pandemic has highlighted why we must optimise COPD treatment in order to better reduce a patient’s risk of exacerbations to slow disease progression, keep patients out of hospital and allow people with COPD to live longer and healthier lives.ġ. 1 However, the current global treatment paradigm is one of failure-driven escalation. In addition to prevention of exacerbations, earlier diagnosis, improving lung function, and managing daily symptoms such as breathlessness, are important treatment goals in the management of COPD. 3 As a respiratory community, reducing the risk of exacerbations should be a priority for treatment because of their impact on mortality. 17 Sadly, 1 in 5 patients will die within one year following their first COPD hospitalisation. 16 Further, damage from a COPD exacerbation goes beyond just the lungs, with the risk of cardiovascular complications such as myocardial infarction and stroke also increased following a moderate exacerbation. 3,4 Just one exacerbation can double the rate of lung function decline 14,15 and increase the risk of a future hospitalisation by 21%. Research has shown that even a single COPD exacerbation may be associated with a significant increase in the rate of decline in lung function, 14,15 deterioration in quality of life 2, and increase the risk of mortality. 3,4 While most patients with COPD will experience exacerbations, they are often not reported by the patient and are therefore left under-treated. Many COPD patients live with the constant threat of an exacerbation – an acute worsening of symptoms which can lead to permanent loss of lung function 8 and increased risk of mortality.
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