Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Buess, Michael; Schilter, Daniel; Schneider, Tino; Maurer, Marc; Borer, H; Thurnheer, Robert; Köhler, Erich; Junker, Lilian; Jahn, Kathleen; Grob, Michael; Rüdiger, Jochen J.; Geiser, Thomas; Helfenstein, Erich; Solèr, Markus; Fiechter, René; Sigrist, Thomas; Brun, Patrick; Barandun, J; Koltai, Eva; Lόpez-Campos, José Luís; Hartl, Sylvia; Roberts, Michael; Schumann, Desiree M.; Tamm, Michael; Stolz, Daiana

doi:10.1159/000477911

Cited by 8 publications

(20 citation statements)

References 33 publications

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“…Moreover, the risk of in-hospital death (5.4%) is slightly elevated compared to other European countries (4.9%) but overall mortality is lower (8.1 vs. 10.9%, respectively) [92]. The recent European COPD audit recommends at least a (venous) blood gas analysis in every patient admitted to hospital with suspected severe exacerbation of COPD [92]. Currently, the number of arterial blood gas samples taken to assess the severity of exacerbations in Switzerland is comparable to other European countries (85.6 vs. 84.1%, respectively) [92].…”

Section: Management Of Exacerbationsmentioning

confidence: 75%

“…In Switzerland, patients with AECOPDs have a prolonged hospital stay compared to patients in other European countries (11.3 vs. 8.7 days; p < 0.001) [92]. Moreover, the risk of in-hospital death (5.4%) is slightly elevated compared to other European countries (4.9%) but overall mortality is lower (8.1 vs. 10.9%, respectively) [92].…”

Section: Management Of Exacerbationsmentioning

confidence: 96%

Section: Management Of Exacerbationsmentioning

confidence: 99%

“…The recent European COPD audit recommends at least a (venous) blood gas analysis in every patient admitted to hospital with suspected severe exacerbation of COPD [92]. Currently, the number of arterial blood gas samples taken to assess the severity of exacerbations in Switzerland is comparable to other European countries (85.6 vs. 84.1%, respectively) [92]. Spirometry should also be performed before a patient is discharged from hospital or at least 4-6 weeks thereafter [92].…”

Section: Management Of Exacerbationsmentioning

confidence: 99%

“…Currently, the number of arterial blood gas samples taken to assess the severity of exacerbations in Switzerland is comparable to other European countries (85.6 vs. 84.1%, respectively) [92]. Spirometry should also be performed before a patient is discharged from hospital or at least 4-6 weeks thereafter [92].…”

Section: Management Of Exacerbationsmentioning

confidence: 99%

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Diagnosis, Prevention and Treatment of Stable COPD and Acute Exacerbations of COPD: The Swiss Recommendations 2018

et al. 2018

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The Swiss National Guidelines 2013 for chronic obstructive pulmonary disease have been revised in order to acknowledge recent progress in diagnosis and management of this disease. The resulting new Swiss recommendations are based on best evidence from the literature, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018 report and other published national guidelines. Misdiagnosis of chronic obstructive pulmonary disease is common and means that patients do not always receive optimal treatment. To improve the management of patients with chronic obstructive pulmonary disease in Switzerland, these recommendations encourage a more comprehensive assessment of patients, based on the combined assessment of symptoms, degree of airflow limitation, risk of exacerbation and the presence of comorbidities. Recommendations for evidence-based preventive measures, as well as pharmacological and non-pharmacological strategies for the management of both stable and acute exacerbations of chronic obstructive pulmonary disease are provided in this update.

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Section: Management Of Exacerbationsmentioning

confidence: 75%

Section: Management Of Exacerbationsmentioning

confidence: 96%

Section: Management Of Exacerbationsmentioning

confidence: 99%

Section: Management Of Exacerbationsmentioning

confidence: 99%

Section: Management Of Exacerbationsmentioning

confidence: 99%

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Diagnosis, Prevention and Treatment of Stable COPD and Acute Exacerbations of COPD: The Swiss Recommendations 2018

et al. 2018

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No evidence of harmful effects of steroids in severe exacerbations of COPD associated with influenza

et al. 2022

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Purpose COPD has large impact on patient morbidity and mortality worldwide. Acute exacerbations (AECOPD) are mostly triggered by respiratory infections including influenza. While corticosteroids are strongly recommended in AECOPD, they are potentially harmful during influenza. We aimed to evaluate if steroid treatment for AECOPD due to influenza may worsen outcomes. Methods A retrospective analysis of a Swiss nation-wide hospitalization database was conducted identifying all AECOPD hospitalisations between 2012 and 2017. In separate analyses, outcomes concerning length-of-stay (LOS), in-hospital mortality, rehospitalisation rate, empyema and aspergillosis were compared between AECOPD during and outside influenza season; AECOPD with and without laboratory-confirmed influenza; and AECOPD plus pneumonia with and without laboratory-confirmed influenza. Results Patients hospitalized for AECOPD during influenza season showed shorter LOS (11.3 vs. 11.6 day, p < 0.001) but higher rehospitalisation rates (33 vs 31%, p < 0.001) compared to those hospitalized outside influenza season. Patients with confirmed influenza infection had lower in-hospital mortality (3.3 vs. 5.5%, p = 0.010) and rehospitalisation rates (29 vs. 37%, p < 0.001) than those without confirmed influenza. Conclusion Using different indicators for influenza as the likely cause of AECOPD, we found no consistent evidence of worse outcomes of AECOPD due to influenza for hospitalized patients. Assuming that most of these patients received corticosteroids, as it is accepted standard of care in Switzerland, this study gives no evidence to change the current practice of using corticosteroids for hospitalized AECOPD independent of the influenza status. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-021-01743-1.

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106 Treatment of COPD exacerbation in Switzerland - results and recommendations of the European COPD Audit

Buess¹,

Schneider

Maurer

et al. 2017

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to examine the quality of care for AECOPD and to provide specific recommendations for the management of severe AECOPD in Switzerland. Methods: A total of 295 patients requiring hospital admission to 19 Swiss hospitals due to exacerbation of COPD during a predefined 60 days in 2011 were included in the study. We compared the Swiss data to the official GOLD 2010 recommendations and to the results of the other European countries. Results: Approximately 43% of the Swiss patients with severe AECOPD were current smokers at hospital admission, compared to 33% of the patients in other European countries (p < 0.001). In Switzerland and in Europe, spirometry data were not available for most patients at hospital admission (65 and 60%, respectively; p = 0.08).

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Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Cited by 8 publications

References 33 publications

Diagnosis, Prevention and Treatment of Stable COPD and Acute Exacerbations of COPD: The Swiss Recommendations 2018

Diagnosis, Prevention and Treatment of Stable COPD and Acute Exacerbations of COPD: The Swiss Recommendations 2018

No evidence of harmful effects of steroids in severe exacerbations of COPD associated with influenza

106 Treatment of COPD exacerbation in Switzerland - results and recommendations of the European COPD Audit

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