Exacerbations in the pre- and post-COPD diagnosis periods

Abstract

PurposeChronic obstructive pulmonary disease (COPD) is usually recognized in its later stages, delaying therapeutic opportunities. Screening questionnaires have modest sensitivities and specificities. Adding questions about prior respiratory events might improve screening characteristics.MethodsUsing administrative data from all health care facilities in Olmsted County, Minnesota USA, we identified all adults with an initial diagnosis of COPD from 2005 through 2007. For each individual we identified all coded lower and upper respiratory events in the 2 years before and the 2 years after the COPD diagnosis and categorized them as probable or possible COPD exacerbations.Results356 women and 346 men (N = 702) with a mean age of 67.5 years and 66.6 years respectively had a first diagnosis of COPD during the study period. Respiratory events in the 2 years prior to a COPD diagnosis were common with a range of 0 to 16 events per individual and a mean (SD) of 2.04 (2.14), 1.38 (1.86) all of which were probable COPD exacerbations. Prediagnostic respiratory events were predictive of similar events in the post diagnostic period (odds ratio = 1.6, 95% confidence interval [CI] 1.3 to 1.8).ConclusionInquiring about the number and type of upper or lower respiratory events in the 2 past years may be a useful addition to the “screening” criteria to improve COPD identification, especially those at risk of frequent exacerbations.

Effect of a short term pulmonary rehabilitation programme on exercise capacity, pulmonary function and health related quality of life in patients with COPD

“…Benefits of PRP include improved exercise capacity and quality of life, irrespective of change in pulmonary function 17, 23, 24. In contrast, this study has shown significant changes in FEV1 after the exercise programme at the end of 3 weeks (p < 0.05) and at the end of 6 weeks (p < 0.05) in the experimental group.…”

“…The increase in exercise capacity or tolerance may be ascribed to improved aerobic capacity of muscle, increased motivation, and desensitization to the sensation of dyspnoea 16 . Improved aerobic capacity of muscle has been shown through an increase in the ability of the muscle to extract oxygen more thoroughly from circulating blood, 17 a decrease in heart rate during exercise, 18 a reduction in exercise-induced oxidative stress, 19 exercise-induced lactic acidosis, and enhanced skeletal muscle oxidative capacity in patients with COPD 20 …”

Mechanisms, Pathophysiology and Currently Proposed Treatments of Chronic Obstructive Pulmonary Disease

“…During COPD exacerbations, LAMA is better than LABA, even when LABA is associated with an inhaled corticosteroid [20]. Unfortunately, chronic corticosteroid use can increase the risk of pneumonia in patients with severe COPD, advanced age, comorbidities, such as cardiovascular disease, skeletal muscle wasting, lung cancer, and osteoporosis, or a history of recently diagnosed pneumonia [196,197], because they are immunomodulators and immunosuppressors.…”

COPD Symptoms and Risk Factors of Respiratory Disorders in Builders

“…Early prevention with the right health care is the patient's first action to prevent exacerbations. Therefore it is necessary to identify risk factors and early symptoms of COPD to prevent the severity of the disease (Yawn et al, 2013).…”

“…Factors that can trigger the risk of COPD are smoking, outdoor and indoor air pollution, occupational exposure (organic and inorganic dust, vapors, and chemical agents), genetic factors, age, gender, lung growth and to prevent disease. Therefore, it is necessary to recognize risk factors and early symptoms of COPD (Yawn et al, 2013). The purpose of this study was to determine the differences in COPD risk factors and early symptoms of COPD occurred between builders with pulmonary function disorders and builders with no pulmonary function disorders.…”