title: Heterogeneity of chronic obstructive pulmonary disease exacerbations: a two-axes classification proposal.
abstract: Exacerbations of chronic obstructive pulmonary disease (COPD) are clinically relevant events with therapeutic and prognostic implications. Yet, they are heterogeneous and can need different therapeutic strategies. In this Viewpoint, we propose an admittedly crude approach to a COPD exacerbation classification that might eventually help to define the most appropriate pharmacological treatment and clinical treatment setting for these patients. Our suggestion is to combine a pathobiological axis (biomarkers) to guide treatment decisions (use of antibiotics, steroids, or both) with a clinical axis (severity score) to decide the organisational context in which to optimally treat the patient. Needless to say, this proposal needs to be researched and eventually validated, refined, or disproved, but we hope that this process will contribute to the improvement of personalised treatment for patients with COPD exacerbations.
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Seville, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: lcampos@separ.es.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Lopez-Campos
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Thorax Institute, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Alvar
authors.initials: A
authors.lastname: Agustí
mesh_terms: D015415:Biomarkers / Q000032:analysis; D000066491:Clinical Decision-Making / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification* / Q000473:pathology; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers