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Evidence Base for Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
- Vincenza Snow, MD;
- Steven Lascher, DVM, MPH;
- Christel Mottur-Pilson, PhD; and
- for the Joint Expert Panel on Chronic Obstructive Pulmonary Disease of the American College of Chest Physicians and the American College of Physicians–American Society of Internal Medicine*
The American College of Physicians–American Society of Internal Medicine (ACP–ASIM) and the American College of Chest Physicians (ACCP) developed this evidence-based clinical practice guideline in collaboration. A joint expert panel examined the evidence and developed recommendations. The numbers in square brackets are cross-references to the numbered sections in the accompanying background paper, “Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Summary and Appraisal of Published Evidence,” which is part 2 of this guideline (see pages 600-620). The guideline and background paper are based primarily on a systematic review compiled in an Agency for Healthcare Research and Policy evidence report prepared by the Evidence-Based Practice Center at Duke University (1). Our target audience is primary care physicians and specialists who care for patients with chronic obstructive pulmonary disease (COPD). Although most acute exacerbations of COPD take place and are treated on an outpatient basis, research studies focus on emergency department or inpatient settings. As a result, this guideline applies to exacerbations treated in those settings. The guideline presents the available evidence on risk stratification for relapse and 6-month mortality rates, diagnostic testing for acute exacerbations of COPD, and current treatment options for acute exacerbations of COPD.
In the United States, 16 million adults have COPD, which accounts annually for 110 000 deaths, more than 16 million office visits, 500 000 hospitalizations, and $18 billion in direct health care costs. The disease is characterized by chronic airflow obstruction and episodic increases in dyspnea, cough, and sputum production that are commonly called “exacerbations.” After an acute exacerbation, most patients experience a transitory or permanent decrease in quality of life, and nearly 50% of patients discharged from hospitals after acute exacerbations are readmitted more than once in the following 6 months. Therefore, one of the main treatment goals for …
This 100-word excerpt has been provided in the absence of an abstract.
