BackgroundRecently, the Rome classification was proposed in which objective and readily measurable variables were integrated to mark exacerbations of COPD (ECOPD) severity. The aim of this study is to investigate the distribution of a real-world patient population with hospitalized ECOPD according to the current classification across the newly proposed severity classification. We assume that a significant proportion of hospitalized patients will have a mild or moderate event.MethodsThe Rome classification was applied to a cohort of 364 COPD patients hospitalized at the Department of Respiratory Medicine of Maastricht University Medical Center (MUMC) with a severe ECOPD. Differences in in-hospital, 30- and 90-days mortality were compared between mild, moderate and severe ECOPD according to the new classification. Moreover, data was stratified by the different severity classes and compared regarding general disease characteristics and clinical parameters.ResultsAccording to the Rome proposal, 52 (14.3%) patients had a mild ECOPD, 204 (56.0%) moderate and 108 (29.7%) patients a severe ECOPD. In-hospital mortality in mild, moderate and severe events was 3.8%, 6.9% and 13.9%, respectively. Most clinical parameters indicated a significantly worse condition in patients classified in the severe group, compared to those in mild or moderate groups.ConclusionMost of the events, traditionally all classified as severe because of the hospitalization, were classified as moderate, while almost 15% were mild. The results of this study provide insight in the heterogeneity of hospitalized ECOPD and show that the newly proposed Rome criteria can differentiate between events with different short-term mortality rates.
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