Establishing the Prognosis of COPD Exacerbations Using Risk Scales from the Point of View of the Emergency Department

Sanz, María Teresa García; Barcala, Francisco Javier González

doi:10.1016/j.arbr.2019.04.017

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Although the multidimensional evaluation of the patient with an exacerbation and the inclusion of scales in decision making could improve the quality of care without compromising patient safety [125] and that there are a number of scales validated for the severity of an exacerbation [126], these scales are not yet recommended in current recommendation documents [42,43]. The next decade should bring the evidence to be able to use these scales in daily clinical practice both at the hospital and in the community.…”

Section: Exacerbations: Rationale For Improvement In Near Futurementioning

confidence: 99%

Ten Research Questions for Improving COPD Care in the Next Decade

Lόpez-Campos

Rodríguez

Quintana‐Gallego

et al. 2019

COPD: Journal of Chronic Obstructive Pulmonary Disease

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With the 60th anniversary of the CIBA symposium, it is worth evaluating research questions that should be prioritized in the future. Coming research initiatives can be summarized in main areas. 1. From epidemiology the impact of new forms of electronic cigarettes on prevalence and mortality of COPD will be sought. 2. The study of the disease endotypes and its relationship phenotypes will have to be unraveled in the next decade. 3. Diagnosis of COPD faces several challenges opening the possibility of a change in the definition of the disease itself. 4. Patients' classification and risk stratification will need to be clarified and reassessed. 5. The asthma-COPD overlap dilemma will have to be clarified and define whether both conditions represent one only chronic airway disease again. 6. Integrating comorbidities in COPD care will be key in a progressively ageing population to improve clinical care in a chronic care model. 7. Non-pharmacological management have areas for research including pulmonary rehabilitation and vaccines. 8. Improving physical activity should focus research because of the clear prognostic impact. 9. Pharmacological therapies present several challenges including efficacy and safety issues with current medications and the development of biological therapy. 10. The definition, identification, categorization and specific therapy of exacerbations will also be an area of research development.During the next decade we have a window of opportunity to address these research questions that will put us on the path for precision medicine.

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Section: Exacerbations: Rationale For Improvement In Near Futurementioning

confidence: 99%

Ten Research Questions for Improving COPD Care in the Next Decade

Lόpez-Campos

Rodríguez

Quintana‐Gallego

et al. 2019

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…Also, the data came from a single hospital and the results should not be generalized to other hospitals. Furthermore, other variable factors that may seem relevant to treatment failure, such as blood eosinophils, serum sodium, FEV1 <30% predicted, and treatment at discharge, were not obtained in this study [ 6 , 29 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the time course of exacerbations varies from patient to patient and there are no standards that can be applied to the timing and nature of discharge [ 5 ]. The decision to admit or discharge is often taken on the basis of clinical criteria identified in the emergency department (ED) or established by the treating physician [ 6 ]. The appropriate disposition decreases mortality and results in cost-effectiveness [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Pethyabarn

Chewae

Dadeh

2020

Emergency Medicine International

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Objective. We aimed to identify factors associated with treatment failure in patients with acute exacerbation of COPD (AECOPD) admitted to the emergency department observation unit (EDOU). Methods. A retrospective cohort study was conducted between January 1, 2013, and October 31, 2019. The electronic medical records were reviewed of patients with AECOPD admitted to the EDOU. The patients were divided into treatment failure and treatment success groups. Treatment failure was defined as prolonged stay at the EDOU (>48 h) or COPD-related ED revisit (within 72 h) or readmission within 1 month. The two groups were compared and analyzed using univariable and multivariable analyses by logistic regression. Results. Of the 220 patients enrolled, 82 (37.3%) developed treatment failure. Factors associated with treatment failure included arrhythmias (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.04–13.9), diabetic mellitus (OR 2.32, 95% CI 1.09–4.95), long-term oxygen therapy (OR 2.89, 95% CI 1.08–7.72), short-acting beta-agonist use (OR 6.06, 95% CI 1.98–18.62), pneumonia findings on chest X-ray (OR 3.24, 95% CI 1.06–9.95), and ED length of stay less than 4 h (OR 2, 95% CI 1.08–3.73). Conclusion. Arrhythmias, diabetic mellitus, long-term oxygen therapy, short-acting beta-agonist use, pneumonia findings on chest X-ray, and ED length of stay <4 h were the significant factors associated with treatment failure of AECOPD to which physicians at the ED should pay special attention before the admission of patients to the EDOU.

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“…1 , 9 , 10 In recent years, various scales have been created to try to predict the progression of COPD exacerbations, and they have proven useful in routine clinical practice. 11 The most recently studied biomarker in COPD is the level of eosinophils in peripheral blood, which seems useful to predict the response to corticosteroids or the risk of exacerbations. However, the results obtained are not homogeneous across studies, as some authors do not observe any relationship between blood eosinophil count and AECOPD.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Usefulness of Basic Analytical Data in Chronic Obstructive Pulmonary Disease Exacerbation

Martínez-Gestoso,

García-Sanz,

Carreira

et al. 2023

Open Respiratory Archives

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Establishing the Prognosis of COPD Exacerbations Using Risk Scales from the Point of View of the Emergency Department

Cited by 7 publications

References 8 publications

Ten Research Questions for Improving COPD Care in the Next Decade

Ten Research Questions for Improving COPD Care in the Next Decade

Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Prognostic Usefulness of Basic Analytical Data in Chronic Obstructive Pulmonary Disease Exacerbation

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