Abstract
BackgroundLimited data are available regarding the impact of the potential validation of the Canadian Thoracic Society (CTS) guidelines recommendations in classifying patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in simple and complex. The aim of the present study was to assess the CTS recommendations regarding risk stratification on clinical outcomes among patients hospitalized with an AECOPD.MethodsWe developed a retrospective cohort study of patients admitted to one tertiary hospital with a diagnosis of AECOPD. The main clinical outcome was the percentage of treatment failure. Secondary outcomes were 30-day, 90-day, and 1-year readmission and mortality rate, length of stay in hospital, intensive care unit (ICU) admission rate, time to readmission, and time to death. Multivariate analyses were performed using 1-year mortality rate as the dependent measures.ResultsOne hundred forty-three patients composed the final study population, most of them (106 [74.1%)] classified as complex acute exacerbation (C-AE) of COPD. C-AE patients had similar rate of treatment failure compared with simple acute exacerbation (S-AE) of COPD (31.1% vs. 27%; p = 0.63). There were no differences regarding the length of stay in hospital, ICU admission rate, and 30-day, 90-day, and 1-year readmission rate. C-AE patients had faster declined measures on time to death (691.6 ± 430 days vs. 998.1 ± 355 days; p = 0.02). In the multivariate analysis, after adjusting for comorbidity, lung function and previous treatment, C-AE patients had a significant higher mortality at one year (Odds Ratio [OR] = 4.9 (Confidence Interval [CI] 95%: 1.16-21); p = 0.031).ConclusionsIn hospitalized patients with an AECOPD, CTS classification, according to the presence of risk factors, was not associated with worse short-term clinical outcomes although it is related with long-term mortality.
Highlights
Chronic Obstructive Pulmonary Disease (COPD) is a major increasing health problem among people [1]
We developed a retrospective cohort study of patients admitted to one tertiary hospital with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD)
complex acute exacerbation (C-AE) patients had similar rate of treatment failure compared with simple acute exacerbation (S-AE) of COPD (31.1% vs. 27%; p = 0.63)
Summary
Chronic Obstructive Pulmonary Disease (COPD) is a major increasing health problem among people [1]. There exists certain heterogeneity between patients, the course of COPD is characterized by recurrent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) [3,4]. Canadian Thoracic Society (CTS) explains in its COPD guidelines [16] that antibiotics are beneficial to treat more severe purulent AECOPD (new increased expectoration of mucopurulent sputum and dyspnea). Limited data are available regarding the validation of the CTS guidelines recommendations in patients hospitalized with AECOPD. Limited data are available regarding the impact of the potential validation of the Canadian Thoracic Society (CTS) guidelines recommendations in classifying patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in simple and complex.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
