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Clinical Assessment, Staging, and Epidemiology of Chronic Obstructive Pulmonary Disease Exacerbations

North West Lung Centre, South Manchester University Hospital Trust, Manchester, United Kingdom; and Department of Cardiology and Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark

Correspondence and requests for reprints should be addressed to Jørgen Vestbo, M.D., Ph.D., North West Lung Centre, South Manchester University Hospital Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK. E-mail: jorgen.vestbo{at}manchester.ac.uk

ABSTRACT

Patients presenting with an exacerbation of chronic obstructive pulmonary disease (COPD) are initially assessed to ensure that a proper diagnosis has been made and that relevant differential diagnoses are excluded. Although guidelines provide indicators for use, very little systematic research has been done in initial assessment of COPD exacerbations. Next, the assessment should aim at stratifying patients for risk of poor outcome. For this, predictors of poor prognosis as well as knowledge of favorable treatments can be used. However, no formal and validated staging system exists today. Given the frequency and impact of COPD exacerbations, there seems to be a need for systematic research in this area.

Key Words: biomarkers • blood gases • chronic obstructive pulmonary disease • lung function • prognosis

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