The aim of the present study was to determine the prevalence of and risk factors for venous thromboembolism (VTE) in exacerbations of chronic obstructive pulmonary disease (COPD).COPD patients hospitalised with an exacerbation were included consecutively. Symptoms, signs and clinical, haematological and epidemiological parameters on admission were noted. All patients underwent computed tomographic angiography and ultrasonographic examination for deep vein thrombosis and pulmonary embolism (PE). Wells and Geneva scores were calculated. Patients were followed-up for 1 yr in order to determine mortality.Deep vein thrombosis and PE were detected in 14 and 18 patients, respectively. The prevalence of VTE was three times higher in patients with an exacerbation of unknown origin than in patients with an exacerbation of known origin (p50.016). Of patients with VTE, 20 (95%) had high D-dimer levels. The negative predictive value of D-dimer testing was 0.98. Although the moderate-and high-risk categories of both the Wells and Geneva methods covered all PE patients, the Wells method identified 49% less potential patients for PE investigation. Mortality at 1 yr was higher (61.9% versus 31.8%) in VTE patients (p50.013).VTE is a common problem in COPD patients hospitalised with an exacerbation, leading to high long-term mortality. D-dimer levels and the Wells criteria can be used to determine whether or not these patients are assessed for a thromboembolic event.

The present study was designed to evaluate the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids (SC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (ECOPD).Patients hospitalised with ECOPD (n5159) were randomised into three groups. Group 1 received only standard bronchodilator treatment (SBDT), group 2 received SC (40 mg prednisolone) plus SBDT, and group 3 received NB (1,500 mg q.i.d.) plus SBDT. Improvement during 10-day hospitalisation was compared with exacerbation and rehospitalisation rates after discharge.While mean¡SD age was 64.1¡8.9 yrs (female/male50.1), mean forced expiratory volume in one second (FEV1) at admission was found to be 37.2¡12.2% predicted. Arterial blood gases and spirograms recovered faster in groups 2 and 3. While improvements in arterial oxygen tension (Pa,O 2 ) and forced vital capacity (FVC) in group 2, and improvements in Pa,O 2 , FVC and FEV1 in group 3, became significant at 24-h control, the first significant improvement in group 1 appeared in arterial oxygen saturation at 72-h control. The mean improvement of Pa,O 2 after 10 days was 1.20 and 1.06 kPa (9 and 8 mmHg) higher in group 2 and 3, respectively, than in group 1. Blood glucose exhibited an upward trend only in group 2.The study demonstrates that nebulised budesonide may be an effective and safe alternative to systemic corticosteroids in the treatment of exacerbations of chronic obstructive pulmonary disease.

ObjectiveThe aim of the study was to determine the nutritional status and anthropometric values in a group of patients with COPD and to examine the relationship between these factors and disease severity.MethodsA total of 105 COPD patients were included in this cross-sectional study. The patients underwent spirometric exmination. Mini nutritional assessment form was applied, and the anthropometric values of the patients were measured by bioelectrical impedance method. Nutrient registration forms were given using a 3-day, 24-hour recall method to assess the nutrient uptake. COPD severity was determined using the Global Initiative for Chronic Obstructive Lung Disease criteria, and the correlations between nutritional status and disease severity parameters were measured.ResultsThe prevalence of malnutrition in our patients with COPD was found to be 17%. Spirometric parameters were found to be significantly lower in patients with low body mass index (BMI) and malnutrition. As the modified Medical Research Council dyspnea scale score increased, the frequency of malnutrition increased (P=0.002). Positive significant correlation was found between spirometric variables and muscle mass and fat external tissue volume of the patients. Patients receiving higher protein content in diet showed a better muscle mass amount (P<0.001).ConclusionOur study results confirmed that malnutrition is an important and frequently encountered problem in COPD patients, and spirometric values of the patients with malnourishment and with low BMI are significantly lower. We think that nutritional status should be evaluated in every COPD patient, and nutritional intake should be tailored individually.

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