<p>Club Cell Secretory Protein (CCSP) is Reduced in Hospitalized Chronic Obstructive Pulmonary Disease (COPD) Exacerbations</p>

Exacerbations have significant impact on the morbidity and mortality of patients with chronic obstructive pulmonary disease. Most guidelines emphasise prevention of exacerbations by treatment with long-acting bronchodilators and/or anti-inflammatory drugs. Whereas most of this treatment is evidence-based, it is clear that patients differ regarding the nature of exacerbations and are likely to benefit differently from different types of treatment. In this short review, we wish to highlight this, suggest a first step in differentiating pharmacological exacerbation prevention and call for more studies in this area. Finally, we wish to highlight that there are perhaps easier ways of achieving similar success in exacerbation prevention using nonpharmacological tools.

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One Year Experience of an Early Assisted Discharge Scheme for Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in the Netherlands.

10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a2379 ◽

2009 ◽

Author(s):

CM Utens ◽

FW Smeenk ◽

MP Rutten-van Molken ◽

CP van Schayck

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

The Netherlands ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Exacerbations ◽

One Year

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Management of chronic obstructive pulmonary disease: A review focusing on exacerbations

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxz306 ◽

2020 ◽

Vol 77 (4) ◽

pp. 259-268

Author(s):

Suzanne G Bollmeier ◽

Aaron P Hartmann

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Patient Education ◽

Disease Management ◽

Pulmonary Disease ◽

The United States ◽

Chronic Obstructive ◽

Severe Exacerbation ◽

Obstructive Pulmonary Disease ◽

Copd Exacerbations ◽

The Impact

Abstract Purpose Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality in the United States. Exacerbations— acute worsening of COPD symptoms—can be mild to severe in nature. Increased healthcare resource use is common among patients with frequent exacerbations, and exacerbations are a major cause of the high 30-day hospital readmission rates associated with COPD. Summary This review provides a concise overview of the literature regarding the impact of COPD exacerbations on both the patient and the healthcare system, the recommendations for pharmacologic management of COPD, and the strategies employed to improve patient care and reduce hospitalizations and readmissions. COPD exacerbations significantly impact patients’ health-related quality of life and disease progression; healthcare costs associated with severe exacerbation-related hospitalization range from $7,000 to $39,200. Timely and appropriate maintenance pharmacotherapy, particularly dual bronchodilators for maximizing bronchodilation, can significantly reduce exacerbations in patients with COPD. Additionally, multidisciplinary disease-management programs include pulmonary rehabilitation, follow-up appointments, aftercare, inhaler training, and patient education that can reduce hospitalizations and readmissions for patients with COPD. Conclusion Maximizing bronchodilation by the appropriate use of maintenance therapy, together with multidisciplinary disease-management and patient education programs, offers opportunities to reduce exacerbations, hospitalizations, and readmissions for patients with COPD.

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Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218072 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8072 ◽

Cited By ~ 1

Author(s):

Kulothungan Gunasekaran ◽

Mudassar Ahmad ◽

Sana Rehman ◽

Bright Thilagar ◽

Kavitha Gopalratnam ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Length Of Stay ◽

Pulmonary Disease ◽

Respiratory Virus ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Exacerbations ◽

The Mean

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters (n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay.

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