One-year Mortality in COPD After an Exacerbation: The Effect of Physical Activity Changes During the Event

Esteban, Cristóbal; García-Gutiérrez, Susana; Legarreta, María José; Antón-Ladislao, Ane; González, Nerea; Lafuente, Iratxe; Larrea, Nerea Fernández de; Vidal, Silvia M.; Baré, Marisa; Quintana, José María

doi:10.1080/15412555.2016.1188903

Cited by 19 publications

(15 citation statements)

References 34 publications

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“…Activity is the strongest predictor of mortality in patients with COPD [69,70], i.e. patients with low levels of physical activity have a higher risk of mortality.…”

Section: Physical Activity and Pulmonary Rehabilitationmentioning

confidence: 99%

Exacerbations of COPD

2018

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Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed. More severe exacerbations should be treated with β-agonists and anticholinergics as well as systemic corticosteroids. Antibiotic therapy should only be given to patients with presumed bacterial infection. Noninvasive ventilation is indicated in patients with respiratory failure. Smoking cessation is key to prevent further COPD exacerbations. Other aspects include choice of pharmacotherapy, including bronchodilators, inhaled corticosteroids, phosphodiesterase-4 inhibitors, longterm antibiotics and mucolytics. Better education and self-management as well as increased physical activity are important. Influenza and pneumococcal vaccination is recommended. Treatment of hypoxaemia and hypercapnia reduce the rate of COPD exacerbations, while most interventional bronchoscopic therapies increase exacerbation risk within the first months after the procedure.

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“…Activity is the strongest predictor of mortality in patients with COPD [69,70], i.e. patients with low levels of physical activity have a higher risk of mortality.…”

Section: Physical Activity and Pulmonary Rehabilitationmentioning

confidence: 99%

Exacerbations of COPD

2018

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“…Exercise training, in the form of pulmonary rehabilitation, is a key tenet in the management of COPD (53). A structured exercise programme improves health-related QoL and reduces the number of admissions (54,55), and reduces mortality (56)(57)(58)(59). A limitation to prolonged exercise training in patients with COPD is the development of dynamic hyperinflation due to an increase in end-expiratory volume caused by expiratory flow limitation and increased respiratory rate (60).…”

Section: Niv As An Adjunct In Exercise Trainingmentioning

confidence: 99%

Update: non-invasive ventilation in chronic obstructive pulmonary disease

Shah¹,

D’Cruz²,

Murphy³

2018

J. Thorac. Dis.

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Chronic obstructive pulmonary disease (COPD) remains a common cause of morbidity and mortality worldwide. Patients with COPD and respiratory failure, whether acute or chronic have a poorer prognosis than patients without respiratory failure. Non-invasive ventilation (NIV) has been shown to be a useful tool in both the acute hospital and chronic home care setting. NIV has been well established as the gold standard therapy for acute decompensated respiratory failure complicating an acute exacerbation of COPD with reduced mortality and intubation rates compared to standard therapy. However, NIV has been increasingly used in other clinical situations such as for weaning from invasive ventilation and to palliate symptoms in patients not suitable for invasive ventilation. The equivocal evidence for the use of NIV in chronic hypercapnic respiratory failure complicating COPD has recently been challenged with data now supporting a role for therapy in selected subgroups of patients. Finally the review will discuss the emerging role of high flow humidified therapy to support or replace NIV in certain clinical situation.

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“…In einer aktuellen Studie erwies sich die körperliche Aktivität als stärkster Prädiktor der Mortalität in dem Jahr nach akuter Exazerbation [48]. Bei den mehr als 2400 Patienten wurde das Ausmaß der körperlichen Aktivität bei stationärer Aufnahme und zwei Monate später verglichen.…”

Section: Risikofaktoren Und Phänotypenunclassified

Expertentreffen COPD: Exazerbation der COPD

et al. 2017

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Acute worsenings of chronic obstructive pulmonary disease (COPD) were for a long time regarded as transient deteriorations, although occasionally life-threatening. No connection to disease progression was recognized. Data emerging during the last decade showed that patients had a considerably worse survival outcome after severe exacerbations. This insight was consolidated in 2012 by a large population-based cohort analysis. At present, severe exacerbations are regarded as key risk factors for COPD disease progression. The present article summarises the current knowledge on exacerbations of COPD, as delineated during an expert workshop in February 2017. It comprises pathogenic mechanisms, exacerbation triggers, the characteristics of frequent exacerbators, and the predictors of worse survival outcome. The role of comorbidities is considered more closely. The presentation of the pharmacotherapy of acute exacerbation is supplemented by an overview of ventilatory support. Finally, pharmacological and nonpharmacological preventive measures are summarised.

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One-year Mortality in COPD After an Exacerbation: The Effect of Physical Activity Changes During the Event

Cited by 19 publications

References 34 publications

Exacerbations of COPD

Exacerbations of COPD

Update: non-invasive ventilation in chronic obstructive pulmonary disease

Expertentreffen COPD: Exazerbation der COPD

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