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. 2006 Dec;15(6):346-53.
doi: 10.1016/j.pcrj.2006.08.009. Epub 2006 Oct 24.

Defining COPD exacerbations: impact on estimation of incidence and burden in primary care

John F O'Reilly  1 , Angela E Williams, Kay Holt, Leanne Rice
Affiliations

Defining COPD exacerbations: impact on estimation of incidence and burden in primary care

John F O'Reilly et al. Prim Care Respir J. 2006 Dec.

Abstract

Aims: To investigate the impact of definition on the incidence of chronic obstructive pulmonary disease (COPD) exacerbations in primary care.

Methods: In a one-year prospective, observational study, data from diary cards were used to determine the incidence of symptom- and healthcare-defined exacerbations. One hundred and twenty seven patients completed > or =80% of days in the diary card and were included in the analysis.

Results: Incidence of COPD exacerbation varied according to definition. Mean yearly rates were 2.3 for symptom- and 2.8 for healthcare-defined exacerbations. Although patients with FEV(1) <50% had a higher mean yearly rate of healthcare-defined exacerbations than those with FEV(1) > or =50% (3.2 vs 2.3; p=0.003), patients with less severe disease reported recurrent exacerbations. There was limited agreement between symptom- and healthcare-defined exacerbations.

Conclusion: Lung function does not appear to be a valid criterion for assigning COPD management directed at patients with recurrent exacerbation.

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