Acute exacerbations as a poor prognostic factor of chronic obstructive pulmonary disease
https://doi.org/10.18093/0869-0189-2018-28-1-104-109
Abstract
This review presents information on severe acute exacerbation of COPD (AECOPD) as an independent negative prognostic factor. Mortality risk increases with the frequency of severe exacerbations, particularly if these require admission to a hospital. Large epidemiological studies in the field of COPD provided sufficient data on potential indicators of increased mortality in COPD. Key predictors of poor prognosis in COPD are the patient’s age, lower forced expiratory volume in 1 second (FEV1), lung hyperinflation, respiratory failure (low PaO2, high PaCO2), pulmonary hypertension, low body mass index, decreased physical tolerance, frequent exacerbations, and comorbidity. Thus, the management of patients with acute exacerbation of COPD still remains as an actual clinical problem.
About the Author
Aung Kyaw Soe
N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia.
Russian Federation
Russian Federation
Aung Kyaw Soe, Postgraduate student, Department of Hospital Internal Medicine, Pediatric Faculty.
ul. Ostrovityanova 1, Moscow, 117997.
References
1. Aisanov Z., Avdeev S., Arkhipov V. et al. Russian experience of creating clinical COPD guidelines and a clinical decision making algorithm. Int. J. COPD. 2018; 13: 183–187.
2. Lozano R., Naghavi M., Foreman K. et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380 (9859): 2095–2128. DOI: 10.1016/S0140-6736(12)61728-0.
3. Eisner M.D., Anthonisen N., Coultas D. et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2010; 182 (5): 693–718. DOI: 10.1164/rccm.200811-1757ST.
4. Rosenberg S.R., Kalhan R., Mannino D.M. Epidemiology of chronic obstructive pulmonary disease: prevalence, morbidity, mortality, and risk factors. Semin. Respir. Crit. Care Med. 2015; 36 (4): 457–469. DOI: 10.1055/s-0035-1555607.
5. Buist A.S., McBurnie M.A., Vollmer W.M. et al. International variation in the prevalence of COPD (the BOLD study): a population-based prevalence study. Lancet. 2007; 370 (9589):741–750. DOI: 10.1016/S0140-6736(07)61377-4.
6. Menezes A.M., Perez-Padilla R., Jardim J.R. et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005; 366 (9500): 1875–1881. DOI: 10.1016/S0140-6736(05)67632-5.
7. Soriano J.B., Ancochea J., Miravitlles M. et al. Recent trends in COPD prevalence in Spain: a repeated cross-sectional survey 1997 – 2007. Eur. Respir. J. 2010; 36 (4): 758–765. DOI: 10.1183/09031936.00138409.
8. Duong M., Islam S., Rangarajan S. et al. Global differences in lung function by region (PURE): an international, community-based prospective study. Lancet Respira. Med. 2013; 1 (8): 599–609. DOI: 10.1016/S2213-2600(13)70164-4.
9. Chuchalin A.G., Khaltaev N., Antonov N.S. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9: 963–974. DOI: 10.2147/COPD.S67283.
10. Artyukhov I.P., Arshukova I.L., Dobretsova E.A. et al. Epidemiology of chronic obstructive pulmonary disease: a population-based study in Krasnoyarsk region, Russia. Int. J. Chron. Obstruct. Pulmon. Dis. 2015; 10: 1781–1786. DOI: 10.2147/COPD.S79601.
11. Ciapponi A., Alison L., Agustina M. et al. The epidemiology and burden of COPD in Latin America and the Caribbean: systematic review and meta-analysis. COPD. 2014; 11 (3): 339–350. DOI: 10.3109/15412555.2013.836479.
12. Siafakas N.M., Vermeire P., Pride N.B. et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. Eur. Respir. J. 1995; 8 (8): 1398–1420.
13. Fletcher C., Peto R. The natural history of chronic airfl¬ow obstruction. Br. Med. J. 1977; 1: 1645e8.
14. Suissa S., Dell’Aniello S., Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012; 67 (11): 957–963. DOI: 10.1136/thoraxjnl-2011-201518.
15. Soler-Cataluna J., Martinez-Garcia M., Roman S. et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005; 60 (11): 925–931. DOI:10.1136/thx.2005.040527.
16. Hoogendoorn M., Hoogenveen R.T., Rutten-van Mölken M.P. et al. Case fatality of COPD exacerbations: a meta-analysis and statistical modeling approach. Eur. Respir. J. 2011; 37 (3): 508–515. DOI: 10.1183/ 09031936.00043710.
17. Hansell A.L., Walk J.A., Soriano J.B. What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis. Eur. Respir. J. 2003; 22 (5): 809–814. DOI: 10.1183/09031936.03.00031403.
18. Mannino D.M., Thorn D., Swensen A., Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur. Respir. J. 2008; 32 (4): 962–969. DOI: 10.1183/09031936.00012408.
19. Nie J.X., Wang L., Upshur R.E. Mortality of elderly patients in Ontario after hospital admission for chronic obstructive pulmonary disease. Can. Respir. J. 2007; 14 (8): 485–489.
20. Celli B.R. Predictors of mortality in COPD. Respir. Med. 2009; 104 (6): 773–779. DOI:10.1016/j.rmed.2009.12.017.
21. Puhan M.A., Garcia-Aymerich J., Frey M. et al. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index. Lancet. 2009; 374 (9691): 704–71. DOI: 10.1016/S0140-6736(09)61301-5.
22. Jones R.C., Donaldson G.C., Chavannes N.H. et al. Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease: the DOSE Index. Am. J. Respir. Crit. Care Med. 2009; 180 (12): 1189–1195. DOI: 10.1164/rccm.200902-0271OC.
23. Steer J., Gibson J., Bourke S.C. The DECAF Score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax. 2012; 67: 970–976. DOI: 10.1136/thoraxjnl-2012-202103.
24. Casanova C., Cote C., de Torres J.P. et al. Inspiratory-to-total lung capacity ratio predicts mortality in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2005; 171: 591–597. DOI: 10.1164/rccm.200407-867OC.
25. Brulotte C.A., Lang E.S. Acute Exacerbations of Chronic Obstructive Pulmonary Disease in the Emergency Department. Emerg. Med. Clin. N. Am. 2012; 30 (2): 223–247. DOI: 10.1016/j.emc.2011.10.005.
26. Hurst J.R., Vestbo J., Anzueto A. et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N. Engl. J. Med. 2010; 363: 1128–38. DOI: 10.1056/NEJMoa0909883.
27. MacDonald M., Beasley R.W., Irving L. et al. A hypothesis to phenotype COPD exacerbations by aetiology. Respirology. 2011; 16: 264–268. DOI: 10.1111/j.1440-1843.2010.01908.x.
28. Bafadhel M., McKenna S., Terry S. et al. Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers. Am. J. Respir. Crit. Care Med. 2011; 184: 662–671. DOI: 10.1164/rccm.201104-0597OC.
29. Anthonisen N.R., Manfreda J., Warren C.P. et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann. Intern. Med. 1987; 106: 196–204. DOI: 10.7326/0003-4819-106-2-196.
30. Martinez F.J., Foster G., Curtis J.L. et al. Predictors of mortality in patients with emphysema and severe airflow obstruction. Am. J. Respir. Crit. Care Med. 2006; 173 (12): 1326–1334. DOI: 10.1164/rccm.200510-1677OC.
31. Brill S.E., Wedzicha J.A. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9: 1241–1252. DOI: 10.2147/COPD.S41476.
32. Roberts C.M., Stone R.A., Buckingham R.J. et al. Acidosis, non-invasive ventilation and mortality in hospitalised COPD exacerbations. Thorax. 2011; 66 (1): 43–48. DOI: 10.1136/thx.2010.153114.
33. Wedzicha J.A., Singh R., Mackay A.J. Acute COPD exacerbations. Clin. Chest Med. 2014; 35 (1): 157–163. DOI: 10.1016/j.ccm.2013.11.001.
34. Barberà J.A., Roca J., Ferrer A. et al. Mechanisms of worsening gas exchange during acute exacerbations of chronic obstructive pulmonary disease. Eur. Respir. J. 1997; 10 (6): 1285–1291.
35. O'Driscoll B.R., Howard L.S., Earis J. et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017; 72 (Suppl. 1): ii1–ii90. DOI: 10.1136/thoraxjnl-2016-209729.
36. Roberts C.M., Stone R.A., Buckingham R.J. et al. Acidosis, non-invasive ventilation and mortality in hospitalised COPD exacerbations. Thorax. 2011; 66: 43–48. DOI: 10.1136/thx.2010.153114.
37. Köhnlein T., Windisch W., Köhler D. et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomized, controlled clinical trial. Lancet Respir. Med. 2014; 2 (9): 698–705. DOI: 10.1016/S2213-2600(14)70153-5.
38. Windisch W. Impact of home mechanical ventilation on health-related quality of life. Eur. Respir. J. 2008; 32: 1328–1336. DOI: 10.1183/09031936.00066407
Review
For citations:
Kyaw Soe A. Acute exacerbations as a poor prognostic factor of chronic obstructive pulmonary disease. PULMONOLOGIYA. 2018;28(1):104-109. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-1-104-109
Views:
1341
Email this article 