International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Multicenter StudyA cross-sectional survey of night-time symptoms and impact of sleep disturbance on symptoms and health status in patients with COPD.
Sleep disturbance has been termed the forgotten dimension of chronic obstructive pulmonary disease (COPD), but it is clinically important as most patients are affected. This study examined the incremental burden of illness associated with sleep disturbance in COPD, with reference to health status and disease impact, and the degree of concordance between physicians and patients in reporting night-time COPD symptoms. ⋯ Night-time symptoms and sleep disturbance are common among patients with COPD, and sleep disturbance has a detrimental impact on COPD symptoms and health status.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Multicenter Study Observational StudyPrevalence and characteristics of asthma-COPD overlap syndrome identified by a stepwise approach.
There is increasing recognition of asthma-COPD overlap syndrome (ACOS), which shares some features of both asthma and COPD; however, the prevalence and characteristics of ACOS are not well understood. The aim of this study was to investigate the prevalence of ACOS among patients with COPD and its characteristics using a stepwise approach as stated in the recent report of the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). ⋯ Using a stepwise approach, as stated in the GINA/GOLD report, the proportions of patients identified as having ACOS were found to be 9.2% and 4.2% (depending on the FEV1 variability cutoff used) among the 1,008 outpatients medically treated for COPD in a real-life clinical setting.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Multicenter Study Observational StudyIdentification and distribution of COPD phenotypes in clinical practice according to Spanish COPD Guidelines: the FENEPOC study.
The Spanish Guidelines for COPD (GesEPOC) describe four clinical phenotypes: non-exacerbator (NE), asthma-COPD overlap syndrome (ACO), frequent exacerbator with emphysema (EE), and exacerbator with chronic bronchitis (ECB). The objective of this study was to determine the frequency of COPD phenotypes, their clinical characteristics, and the availability of diagnostic tools to classify COPD phenotypes in clinical practice. ⋯ In Spanish clinical practice, almost half of the patients with COPD presented with NE phenotype. The prevalence of ACO according to the Spanish consensus definition was very low. In general, physicians indicated that they had the necessary tools for diagnosing COPD phenotypes.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Multicenter Study Comparative StudyTreatment trends in patients with asthma-COPD overlap syndrome in a COPD cohort: findings from a real-world survey.
Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. ⋯ The majority of patients with ACOS, as defined in this research, were prescribed similar treatment to those with COPD. There is a need, however, for better treatment for patients with ACOS, as indicated by symptoms and exacerbation levels. A clearer therapeutic approach for patients with ACOS is required.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Multicenter Study Observational StudyDelayed but successful response to noninvasive ventilation in COPD patients with acute hypercapnic respiratory failure.
We evaluated a new noninvasive ventilation (NIV) protocol that allows the pursuit of NIV in the case of persistent severe respiratory acidosis despite a first NIV challenge in COPD patients with acute hypercapnic respiratory failure (AHRF). ⋯ Most of the COPD patients with AHRF have a successful outcome when NIV is pursued despite a persistent severe respiratory acidosis after the first NIV trial. The outcome of delayed responders is similar to the one of the early responders. On the contrary, the second episode of AHRF during the hospital stay carries a poor prognosis.