Management of acute COPD exacerbations

Chronic obstructive pulmonary disease (COPD) is a very common disease whose evolution is punctuated by episodes of acute exacerbations (AE). The aim of this study was to investigate the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of acute exacerbations of COPD in patients hospitalised in a pulmonary department over a period of 9 years, and to look for factors predictive of severity. Seventy patients with COPD and AE were included. The mean age of our patients was 66.1 years with a clear male predominance. Smoking intoxication was noted in 68 patients (97.1%). During the study period, 165 AEs required hospitalization in the pulmonary department and 181 AEs were treated as outpatients. One hundred and twenty-nine episodes of hospitalised AE (78.2%) met the definition of a severe exacerbation. Factors correlated with severe exacerbations were active smoking, hyperleukocytosis, high CRP, hypoxaemia, hypercapnia and respiratory acidosis.