Pulmonology Pulmonology
Pulmonol 2018;24:42-7 - Vol. 24 Num.1 DOI: 10.1016/j.rppnen.2017.10.006
Review
Identification and assessment of COPD exacerbations
A.S. Oliveiraa, J. Munháb, A. Bugalhoc,d, M. Guimarãese, G. Reisf, A. Marquesg,, , on behalf of GI DPOC – Grupo de Interesse na Doença Pulmonar Obstrutiva Cronica
a Pulmonology Department, Hospital Pulido Valente, CHLN, Lisbon, Portugal
b Pulmonology Department, Centro Hospitalar do Barlavento Algarvio, EPE, Portimão, Portugal
c Pulmonology Department, Hospital CUF Infante Santo/Hospital CUF Descobertas, Lisbon, Portugal
d Chronic Diseases Research Center (CEDOC), Lisbon School of Medical Sciences, Nova University, Lisbon, Portugal
e Pulmonology Department, Centro Hospitalar Gaia-Espinho, EPE, Portugal
f Pulmonology Department, Hospital Distrital de Santarém, Portugal
g Pulmonology Department, São João Hospital Center, Porto, Portugal
Received 19 October 2017, Accepted 30 October 2017
Abstract

Chronic Obstructive Pulmonary Disease (COPD) exacerbations play a central role in the disease natural history of the disease, affecting its overall severity, decreasing pulmonary function, worsening underlying co-morbidities, impairing quality of life (QoL) and leading to severe morbidity and mortality. Therefore, identification and correct assessment of COPD exacerbations is paramount, given it will strongly influence therapy success. For the identification of exacerbations, several questionnaires exist, with varying degrees of complexity. However, most questionnaires remain of limited clinical utility, and symptom scales seem to be more useful in clinical practice. In the assessment of exacerbations, the type and degree of severity should be ascertained in order to define the management setting and optimize treatment options. Still, a consensual and universal classification system to assess the severity and type of an exacerbation is lacking, and there are no established criteria for less severely ill patients not requiring hospital assessment. This might lead to under-reporting of minor to moderate exacerbations, which has an impact on patients’ health status.

There is a clear unmet need to develop clinically useful questionnaires and a comprehensive system to evaluate the severity of exacerbations that can be used in all settings, from primary health care to general hospitals.

Keywords
COPD, Assessment, Severity, Questionnaire, Exacerbations
Pulmonol 2018;24:42-7 - Vol. 24 Num.1 DOI: 10.1016/j.rppnen.2017.10.006
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