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@article{Seemungal:1997,
author = {Seemungal, T and Donaldson, GC and Bhowmik, A and Wedzicha, JA},
journal = {Thorax},
title = {Monitoring and reporting of COPD exacerbations in the community},
volume = {52},
year = {1997}
}
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TY - JOUR
AB - Exacerbations are an important outcome measure in COPD patients. As patients are accustomed to chronic disability, they may under-report exacerbations to doctors. We have studied all exacerbations over 1 year, including reported and unreported ones to assess any differences. Between October 1995 and September 1996, a group of 70 COPD patients (52M, 18F, mean(sd) age 67.5(8.3) yrs, FEV1 1.07(0.44) 1, FVC 2.50(0.80) 1, FEV1 reversibility 6.6 (9.6)%, PaO2 8.8 (1.1) kPa, PaCO2 6.1(1.0) kPa COPD patients recorded on diary cards, daily peak flow rate(PEFR) and changes in respiratory symptoms. A sub-cohort of 26 also recorded daily FEV1 and FVC. Diagnosis of exacerbation(E) was made using criteria based on Anthonisen et al (Ann Intern Med. 1987:106; 196-204): Type 1 - all 3 major symptoms (increase in dyspnoea, sputum purulence and increased sputum volume); Type 2 - two of above; Type 3 - one above, with one minor symptom. 61 patients had 190 E (median 3, range 1-8) of which 93 were reported and 91 unreported (symptom data absent for 7). 183 exacerbations were classified into type 1 (n = 30), type2 (n = 73), and type 3 (n = 80). Over the 2 days prior to onset of exacerbation peak flow fell by a median(IQR) of -4.0 (-20,0) l/min (p < 0.001). There were no differences between reported and unreported exacerbations for the major symptoms of increased dyspnoea (p=0.15) and sputum volume and purulence(p>0.5 for both), type of exacerbation (p = 0.17), number of exacerbations recorded (p = 0.86), PEFR change (p = 0.66) or duration of that change (p = 0.34). For the minor symptoms, reported exacerbations were associated with increased cough (p=0.02), but a lower incidence of increased wheeze (p=0.03). There were no major differences between reported and unreported exacerbations. However exacerbations associated with increased cough were more frequently reported. Diary card monitoring of exacerbation by symptom, PEFR and FEV1 provides accurate documentation of exacerbation occ
AU - Seemungal,T
AU - Donaldson,GC
AU - Bhowmik,A
AU - Wedzicha,JA
PY - 1997///
SN - 0040-6376
TI - Monitoring and reporting of COPD exacerbations in the community
T2 - Thorax
VL - 52
ER -