Diagnosis of COPD exacerbations on hospital admission: Results from the European COPD audit

Abstract

Background: The suspicion of COPD in acute admissions for exacerbation is based on clinical findings and supporting test results. The features of patients with suspected COPD and the results of the main diagnostic tests in 13 European countries have been evaluated. Methodology: Prospective observational study in which all participating hospitals collected data from all COPD admissions during a 60 d period. The preliminary results of 8,664 (73.6%) completed records out of 11,765 study cases are reported. Results: Patient characteristics: mean age 70.5±10 yrs.; 67% male; mean BMI: 26±8.9 kg/m 2 , 28.5% current smokers; mean 51±37.2pack-years. Spirometry (recorded within last 6 month) in 48.2% (mean FEV1 41.9±19.2% predicted). Symptoms distribution and the availability of diagnostic tests is reflected in the figures. The classical triad of symptoms was reported in 40.2% of the pts. BGA on admission was measured in 74% and chest-x-ray was performed in 86.6% of the pts. Conclusion: These results help us characterise unselected COPD exacerbations as seen in clinical practice. Whilst most are admitted with dyspnea, only a minority shows the classical triad of symptoms. The high number of current smokers and the low availability of spirometry suggest to improve implementation of evidence based interventions. The severe stage of COPD in the majority of hospital admissions would justify BGA and x-ray in all patients.