Chest
Original ResearchImpact of COPD Exacerbations on Patient-Centered Outcomes
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Patients
Patients with a diagnosis of COPD, according to the criteria of the American Thoracic Society (ATS),25were recruited between June 2001 and June 2004, and were followed up until May 2006 at one of the BODE Cohort Study Centers. The inclusion/exclusion criteria have been previously published.16The study was prospective and observational, and included 205 consecutive patients. All patients signed a consent form, and the protocol was approved by the Internal Review Board.
Measurements
Pulmonary function tests26
Results
The cohort consisted primarily of men. A total of 1.5% of patients were in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I, 32% in GOLD stage II, 45% in GOLD stage III, and 21.5% in GOLD stage IV. One hundred thirty patients experienced exacerbations; 75 patients who did not experience exacerbations during the same period served as control subjects. The median exacerbation rate was 1 episode per patient; therefore we defined those patients experiencing two or more
Discussion
This study provides us with the following three important findings: first, the BODE index captures short-term changes during moderate exacerbations. Second, exacerbations are important determinants of the rate of change in BODE index over time. Third, patients who do not experience an exacerbation have little change in BODE index scores.
It is known that exacerbations contribute to a further loss of FEV1,4, 10a worsening of HRQOL,11a high socioeconomic burden,6, 8and an increase in mortality.9,
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