title: Particularities of COPD exacerbations in different phenotypes of the disease in Tunisia.
abstract: BACKGROUND
  Chronic Obstructive Pulmonary Disease is defined by a limitation of airflow. This disease is characterized by exacerbations that threaten the patient's life and worsens his prognosis. Moreover, COPD patients are different according to many parameters that define different phenotypes. Characteristics of exacerbations may depend on these phenotypes according to few recent studies.
  
  
  OBJECTIVE
  To determine the characteristics and the prognosis of the exacerbations in each phenotype of COPD patients phenotype in Tunisia.
  
  
  METHODS
  Retrospective study including 153 male patients hospitalized for COPD exacerbation from January 2009 to June 2012. Patients were classified into 4 phenotypes according to Burgel's classification.
  
  
  RESULTS
  Patients were divided into four phenotypes: phenotype (PH)1: (n=68), PH2: (n=33), PH3: (n=25) and PH4: (n=27). Mean age for PH1, 2, 3 and 4 was: 61, 74, 56 and 72 years. The number of exacerbations per year was higher in PH1. Dyspnea was more important in PH1 and 4. Hypercapnia on admission was higher in PH4. Non invasive ventilation and transfer to resuscitation unit were more frequently mandatory in PH3 and 4.   Death occurred 2% of PH1 and 5% of PH4. Hospitalization duration was more important in PH4.
  
  
  CONCLUSIONS
  COPD patients are heterogenous and belong to different phenotypes. The characteristics of the exacerbations and their prognosis widely differ according to these different groups. In Tunisia, it seems that patients who had moderate respiratory functional tests impairment are the lowest responders to treatment with a higher frequency of resuscitation unit transfer.
authors: Ines
authors: I
authors: Zendah
authors: Khadija
authors: K
authors: Ayed
authors: Hamida
authors: H
authors: Kwas
authors: Amel
authors: A
authors: Khattab
authors: Habib
authors: H
authors: Ghédira
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification* / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014416:Tunisia