COPD

Question 1

Define an acute exacerbation of COPD

Answer 1

An increase in COPD symptoms (breathlessness, cough, sputum volume/purulent) above baseline for a sustained period, usually requiring additional treatment

This definition is not ideal as it is non specific and includes the need for treatment which may vary by patient and healthcare system. Patients with COPD often have variations in symptoms day to day so differentiating variation from exacerbation is challenging. Increasing use of biomarkers to identify and phenotype exacerbations is helping/will help in the future.

Question 2

Describe the mortality and morbidity associated with an acute exacerbation of COPD

Answer 2

The failure rate of community COPD exacerbation treatment is up to 26%. Hospitalisation is associated with a short term mortality of 10-14% rising to 25% if the patient is admitted to the ICU.
COPD exacerbation is also associated with increased long term mortality (partly from CV disease), and reduced QoL.