In a previous study using chart abstraction, we found that relying on ICD-9 billing codes may lead to overdiagnosis of COPD exacerbations in up to 25% of patients, potentially because confirmatory testing (e.g. spirometry) to document obstructive lung disease is rarely performed [ 12].
For patients who visited the GP with several exacerbations during follow up, the first exacerbation was, as a rule, included in the analysis.
A case-cohort study of 118 patients with severe COPD attended at a Respiratory Day Unit for an acute infectious exacerbation and followed up over one year.
In our study, patients who had at least one exacerbation during follow-up presented with higher SGRQ scores at baseline when compared to patients without exacerbations.
When receiving an annual follow-up, exacerbation OR at index contact lowered for patients with lung disease (OR = 0.68), psychiatric disease (OR = 0.42), or ≥2 diseases (OR = 0.61).
To complete a systematic review of the literature describing associations between all environmental exposures and asthma symptoms and exacerbations in children up to mean age of 9 years.
Two (4%) children in the adenoidectomy group experienced an adverse event: one child was admitted to hospital for an asthma exacerbation during follow-up and in one child a primary tooth was broken when the mouth gag was inserted.
Self-reported shortness of breath was a significant predictor of exacerbation the follow-up year (two or more) in the univariable analysis like in the ECLIPSE study, but this symptom did not reach statistical significance in multivariate analysis in either of the studies.
By means of this unique cohort-nested RCT design, the likelihood that patients with a COPD exacerbation will be picked up is higher.
