Time course and pattern of COPD exacerbation onset
Time course and pattern of COPD exacerbation onset
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DOI：
10.1136/thoraxjnl-2011-200768
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发表时间：
2012-03-01
期刊：
影响因子：
10
通讯作者：
Wedzicha, Jadwiga A.
中科院分区：
文献类型：
--
作者：
Aaron, Shawn D.;Donaldson, Gavin C.;Wedzicha, Jadwiga A.
背景慢性阻塞性肺疾病（COPD）急性加重事件发生的自然史和时间过程尚不完全清楚，方法采用每日症状日记监测212例COPD患者的前瞻性队列，中位数为2.8年，以确定COPD急性加重发作的时间过程。使用基于加权自我报告症状的决策规则来定义急性加重事件的开始和结束。事件的时间间隔进行了分析和Logistic回归分析，以确定患者的协变量对急性加重events.Results患者记录4439发作的呼吸道症状恶化从基线; 2444（55%）事件自发解决和1995年（45%）导致COPD急性加重。在1995年COPD急性加重中，有1115例（56%）是突然发作，在症状开始的同一天超过急性加重阈值。相反，44%的急性加重的特征是症状逐渐发作（从症状发作到急性加重的中位持续时间4天）。突发急性发作的患者的平均每日症状评分更高（7.86分vs 6.55分，p
Background The natural history and time course of the onset of exacerbation events of chronic obstructive pulmonary disease (COPD) is incompletely understood.Methods A prospective cohort of 212 patients with COPD was monitored using daily symptom diaries for a median of 2.8 years to characterise the time course of COPD exacerbation onset. Decision rules based on weighted self-reported symptoms were used to define opening and closing of exacerbation events. Event time intervals were analysed and logistic regression was used to determine the effects of patient covariates on exacerbation events.Results Patients recorded 4439 episodes of worsening respiratory symptoms from baseline; 2444 (55%) events resolved spontaneously and 1995 (45%) resulted in a COPD exacerbation. In 1115 of the 1995 COPD exacerbations (56%) the onset was sudden and the exacerbation threshold was crossed on the same day symptoms began. In contrast, 44% of exacerbations were characterised by gradual onset of symptoms (median duration from symptom onset to exacerbation 4 days). Patients who experienced sudden onset exacerbations had greater mean daily symptom scores (7.86 vs 6.55 points, p