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Exacerbations of Chronic Obstructive Pulmonary Disease Tool to assess the efficacy of acute treatment.

ABSTRACT: Background and objective:The Exacerbations of Chronic Obstructive Pulmonary Disease Tool-Patient-Reported Outcomes (EXACT-PRO) has been suggested as a reliable and valid measure for early assessment of COPD exacerbations and perceived recovery. However, there has been no evidence for EXACT-PRO efficacy in assessing recovery from treatment in a randomized controlled trial. The study evaluated the reliability, validity, and responsiveness of EXACT-PRO for the evaluation of the efficacy of acute treatment in patients with COPD exacerbation. Methods:In a Phase III randomized controlled study for assessing the efficacy of antibiotic treatment on COPD exacerbation, EXACT-PRO was evaluated in the responders and non-responders. Results:A total of 295 patients were analyzed (259 responders and 37 non-responders). Cronbach's ? was 0.96 for EXACT total, 0.96 for the breathlessness domain, 0.89 for the cough and sputum domain, and 0.93 for the chest symptoms domain. The EXACT score correlated with the COPD assessment test (CAT) score (r=0.8, P<0.01). A stronger decrease in the EXACT score was found in the responder group than in the non-responder group from the fifth day after treatment. The difference in the EXACT score from exacerbation onset to recovery was -6.3 in responders and -1.9 in non-responders (P=0.01). Conclusion:EXACT-PRO is a comprehensive and sensitive method for assessing symptomatic resolution of COPD exacerbations during treatment.

SUBMITTER: Choi HS

PROVIDER: S-EPMC6394236 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Exacerbations of Chronic Obstructive Pulmonary Disease Tool to assess the efficacy of acute treatment.

Choi Hye Sook HS Park Yong Bum YB Shin Kyeong Cheol KC Jang Seung Hun SH Choe Kang Hyeon KH Kim Young Sam YS Kyung Sun Young SY Yoon Sung Ho SH Kim Ju Sang JS Jung Sung Soo SS

International journal of chronic obstructive pulmonary disease 20190225

<h4>Background and objective</h4>The Exacerbations of Chronic Obstructive Pulmonary Disease Tool-Patient-Reported Outcomes (EXACT-PRO) has been suggested as a reliable and valid measure for early assessment of COPD exacerbations and perceived recovery. However, there has been no evidence for EXACT-PRO efficacy in assessing recovery from treatment in a randomized controlled trial. The study evaluated the reliability, validity, and responsiveness of EXACT-PRO for the evaluation of the efficacy of ...[more]

PMID: 30880937

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Project description:BACKGROUND:Antimicrobial treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains controversial. In some cases AECOPD are caused by microorganisms that are resistant to treatments recommended by guidelines. Our aims were: 1) identify the risk factors associated with infection by microorganisms resistant to conventional treatment (MRCT), 2) Compare the clinical characteristics and outcomes of patients with AECOPD resulting from MRCT against those with AECOPD from other causes. METHODS:We prospective analysed a cohort of patients admitted with severe AECOPD (2009 to 2015) who were assigned to three groups: patients with MRCT (those patients with germs resistant to antibiotics recommended in guidelines), patients with microorganisms sensitive to conventional antimicrobial treatment (MSCT), and patients with negative microbiology results who had not previously received antibiotics. Multinomial logistic regression analyses were used to examine the associations between microbial aetiology groups and risk factors. The association between LOS and risk factors was also tested in simple and multiple analyses, and similar inclusion criteria were applied for the linear regression analysis. RESULTS:Of the 451 patients admitted, 195 patients (43%) were included. Respiratory cultures were positive in 86(44%) and negative in 109(56%). MRCT were isolated in 34 cases (40%) and MSCT in 52 (60%). Patients with MRCT had more AECOPD in the previous year, received more antibiotic treatment in the previous three months, had more severe disease, higher dyspnoea and a positive respiratory culture in the previous year (mainly for Pseudomonas aeruginosa). The following conditions were independent factors for MRCT isolation: non-current smoker (odds ratio [OR] 4.19 [95% confidence interval [CI] 1.29-13.67], p?=?0.017), ??2 AECOPD or???1 admission for AECOPD in the previous year (OR 4.13 [95% CI 1.52-11.17], p?=?0.005), C-reactive protein <?5 mg/dL; (OR 3.58 [95% CI 1.41-9.07], p?=?0.007). Mortality rates were comparable at 30-days, one year and 3 years; however, patients in the MRCT group had longer hospital stays. CONCLUSION:In conclusion, there are risk factors for resistant germs in AECOPD; however, the presence of these germs does not increase mortality. Patients with isolation of MRCT had longer length of stay.

Dataset Information

Exacerbations of Chronic Obstructive Pulmonary Disease Tool to assess the efficacy of acute treatment.

Publications

Exacerbations of Chronic Obstructive Pulmonary Disease Tool to assess the efficacy of acute treatment.

Similar Datasets

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