Chest
Original ResearchCOPDReported and Unreported Exacerbations of COPD: Analysis by Diary Cards
Section snippets
Materials and Methods
Patients attending the α1-Antitrypsin Deficiency Assessment Program and Treatment Research Unit at Queen Elizabeth Hospital, Birmingham, UK, who matched the selection criteria were enrolled into the α1 augmentation “EXACTLE” trial. Ethical approval for this study was obtained from University Hospital Birmingham NHS trust research and ethics committee. All patients provided written informed consents before recruitment into the study and filled in daily diary cards. During the run-in period, the
Baseline Characteristics
A total of 19 patients who completed the study maintained daily diary cards for 2 years. All had α1-antitrypsin deficiency of the PiZ type confirmed by isoelectric focusing. These patients (6 female, 13 male) had a mean age of 52.5 years (SE 2.2), an average (± SE) postbronchodilator FEV1 of 1.19 ± 0.1 L (FEV1 percentage of predicted, 39.09 ± 3.5%), and gas transfer corrected for alveolar volume of 0.9 ± 0.1 mmol/min/kPa/L (gas transfer corrected for alveolar volume percentage of predicted,
Discussion
The current study describes a novel approach to the monitoring of exacerbations relevant to COPD. Uniquely, it develops a scoring system to quantify the symptomatology related to the classical criteria described by Anthonisen and colleagues.17 The analysis identifies a sustained change in symptomatology that indicates to the start of the episode and the converse to define the end of the episode. Using this approach, we have identified that the resolution of symptom varies, with changes in
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2019, ChestCitation Excerpt :There also may have been exacerbations not reported. Several studies have shown that many exacerbations noted by symptom diaries were not reported to a health-care professional.27,28 In addition, given the discrepancy between the numbers in the classic CB+ and SGRQ CB+ groups, there may be some misclassification bias.
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Dr. Vijayasaratha has no conflict of interest to disclose. Dr. Stockley is a member of the Alpha One International Registry.
This work was funded by an unrestricted grant from Talecris Biotherapeutics, Research Triangle Park, NC.