[Characteristics and management of acute exacerbations of COPD in hospital. EABPCO-CPHG study by the college of general hospital respiratory physicians].
BACKGROUND
A cohort was formed to explore the evolution of COPD patients treated in general hospitals for acute exacerbations (AE). The present article describes and compares patient characteristics according to whether COPD was diagnosed before the AE or not.


METHODS
Data were analyzed for 1,824 patients admitted between October 2006 and June 2007 to 68 departments of respiratory medicine.


RESULTS
Population characteristics were: male, 77%; mean age, 70.3+/-11.3 years; current smokers, 33%; baseline grade 3-4 dyspnoea, 47%; FEV1<or=50% predicted, 63%. The 290 patients (15.9%) with AE preceding the diagnosis of COPD tended to be younger, female, smokers and had less severe baseline dyspnoea and airflow obstruction. Even so, 21% had grade 3-4 dyspnoea and 44% had FEV1<or=50% predicted. At the onset of the AE, they exhibited as many signs of severity and they required intensive care and assisted ventilation as often as the patients in whom the AE followed a diagnosis of COPD.


CONCLUSIONS
When an AE precedes the diagnosis of COPD, the morbidity of the COPD and the AE is far from negligible, justifying efforts to achieve an earlier diagnosis of COPD.
Piquet
J
J
Service de pneumologie, CHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France. jpiquet@ch-montfermeil.fr <jpiquet@ch-montfermeil.fr>
Chavaillon
J-M
JM
David
P
P
Martin
F
F
Braun
D
D
Ferrer Lopez
P
P
Chemery
L
L
Bénichou-Flurin
M
M
Goupil
F
F
Le Poulain-Doubliez
M
M
Arvin-Berod
C
C
Moncelly
L
L
Lebas
F-X
FX
Maurer
C
C
Dujon
C
C
Mornet
M
M
Roche
N
N
Zureik
M
M
Blanchon
F
F
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D005602:France; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology