Consolidation and Exacerbation of COPD

Hurst, John R.

doi:10.3390/medsci6020044

Cited by 11 publications

(12 citation statements)

References 17 publications

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“…58 Differentiating between these two events poses significant challenges. [58][59][60][61] Both hospitalization due to severe exacerbations and pneumonia have a profound impact on patient outcomes, supporting the idea that clinical trials should evaluate these events together as a composite outcome of hospitalized respiratory events, as recently reported for the IMPACT trial. 62 In that trial, triple therapy with FF/UMEC/VI resulted in a significant 17% reduction in the risk of a severe exacerbation or hospitalized pneumonia compared with UMEC/VI (P=0.011).…”

Section: Benefit Versus Risk With Sittsupporting

confidence: 62%

Benefit/Risk Profile of Single-Inhaler Triple Therapy in COPD

Bourbeau¹,

Bafadhel²,

Barnes³

et al. 2021

COPD

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Section: Benefit Versus Risk With Sittsupporting

confidence: 62%

Benefit/Risk Profile of Single-Inhaler Triple Therapy in COPD

Bourbeau¹,

Bafadhel²,

Barnes³

et al. 2021

COPD

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“…In the European COPD audit, it is notable that the presence of infiltrates was not associated with prior use of inhaled steroids. A similar 2014 UK COPD Audit found the same 19% rate of consolidation at the time of admission for exacerbation and again the risk of mortality in that group was higher than that in those without infiltrates (6.7% vs. 3.6%) ( 19 , 20 ). The presence of consolidation is also included in the Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) prognostic scoring system for in-hospital mortality during exacerbations that has been prospectively validated ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 96%

Risk of Exacerbation and Pneumonia with Single-Inhaler Triple versus Dual Therapy in IMPACT

et al. 2021

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and NC Day were involved in data analysis/interpretation. DA Lipson was involved in conception/design and data analysis/interpretation.Disclosure Statement: This study was funded by GlaxoSmithKline (GSK study number CTT116855). The funders of the study had a role in the study design, data analysis, data interpretation and writing of the report. Editorial support (in the form of assembling figures,

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“…Therefore, it is unsurprising that there is confusion as to what diagnostic label to use in hospitalised COPD patients with radiographic consolidation. This has resulted in the use of a number of different terms such as “pneumonic exacerbation of COPD”, “COPD exacerbation with consolidation”, “community-acquired pneumonia in a patient with COPD” and “COPD exacerbation and pneumonia”, none of which has been universally accepted [11, 15, 23]. Clinicians often make a diagnosis of acute exacerbation in COPD patients even when there is radiographic evidence of consolidation.…”

Section: Discussionmentioning

confidence: 99%

Validity of the diagnosis of pneumonia in hospitalised patients with COPD

et al. 2019

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RationaleExacerbations of chronic obstructive pulmonary disease (COPD) and pneumonia are two of the most common reasons for acute hospital admissions. Acute exacerbations and pneumonia present with similar symptoms in COPD patients, representing a diagnostic challenge with a significant impact on patient outcomes. The objectives of this study were to compare the prevalence of radiographic consolidation with the discharge diagnoses of hospitalised COPD patients.MethodsCOPD patients admitted to three UK hospitals over a 3-year period were identified. Participants were included if they were admitted with an acute respiratory illness, COPD was confirmed by spirometry and a chest radiograph was performed within 24 h of admission. Pneumonia was defined as consolidation on chest radiograph reviewed by two independent observersResultsThere were 941 admissions in 621 patients included in the final analysis. In 235 admissions, consolidation was present on chest radiography and there were 706 admissions without consolidation. Of the 235 admissions with consolidation, only 42.9% had a discharge diagnosis of pneumonia; 90.7% of patients without consolidation had a discharge diagnosis of COPD exacerbation. The presence of consolidation was associated with increased rate of high-dependency care admission, increased mortality and prolonged length of stay. Inhaled corticosteroid use was associated with recurrent pneumonia.ConclusionsPneumonia is underdiagnosed in patients with COPD. Radiographic consolidation is associated with worse outcomes and prolonged length of stay. Incorrect diagnosis could result in inappropriate use of inhaled corticosteroids. Future guidelines should specifically address the diagnosis and management of pneumonia in COPD.

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Consolidation and Exacerbation of COPD

Cited by 11 publications

References 17 publications

Benefit/Risk Profile of Single-Inhaler Triple Therapy in COPD

Benefit/Risk Profile of Single-Inhaler Triple Therapy in COPD

Risk of Exacerbation and Pneumonia with Single-Inhaler Triple versus Dual Therapy in IMPACT

Validity of the diagnosis of pneumonia in hospitalised patients with COPD

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