Standardisation of Clinical Assessment, Management and Follow-Up of Acute Hospitalised Exacerbation of COPD: A Europe-Wide Consensus

被引:16
|
作者
Ramakrishnan, Sanjay [1 ,2 ,3 ]
Janssens, Wim [4 ]
Burgel, Pierre-Regis [5 ,6 ]
Contoli, Marco [7 ]
Franssen, Frits M. E. [8 ]
Greening, Neil J. [9 ]
Greulich, Timm [10 ]
Gyselinck, Iwein [4 ]
Halner, Andreas [1 ]
Huerta, Arturo [11 ]
Morgan, Rebecca L. [12 ]
Quint, Jennifer K. [13 ]
Vanfleteren, Lowie E. G. W. [14 ]
Vermeersch, Kristina [4 ]
Watz, Henrik [15 ]
Bafadhel, Mona [1 ]
机构
[1] Univ Oxford, Nuffield Dept Med Expt Med, Resp Med Unit, Oxford, England
[2] Univ Oxford, Natl Inst Hlth Res NIHR Oxford Biomed Res Ctr BRC, Oxford, England
[3] Edith Cowan Univ, Sch Med & Hlth Sci, Perth, WA, Australia
[4] Katholieke Univ Leuven, Dept Resp Dis, Res Grp BREATHE, UZ Leuven, Leuven, Belgium
[5] Univ Paris, Fac Med, Paris, France
[6] Cochin Hosp, AP HP, INSERM 1016 Inst Cochin, Paris, France
[7] Univ Ferrara, Dept Morphol Surg & Expt Med, Ferrara, Italy
[8] Maastricht Univ, Dept Resp Med, Med Ctr, Maastricht, Netherlands
[9] NIHR Leicester Biomed Res Ctr Resp, Glenfield Hosp, Dept Resp Sci, Leicester, Leics, England
[10] Philipps Univ, Univ Med Ctr Giessen & Marburg, German Ctr Lung Res DZL, Dept Med Pulm & Crit Care Med, Marburg, Germany
[11] IDIBAPS August Pi I Sunyer Biomed Res Inst, Pulm & Crit Care Div, Clin Sagrada Familia, Barcelona, Spain
[12] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
[13] Imperial Coll, Natl Heart & Lung Inst, London, England
[14] Sahlgrens Univ Hosp, COPD Ctr, Dept Internal Med & Clin Nutr, Inst Med,SU Sahlgrenska,Dept Resp Med & Allergol, Gothenburg, Sweden
[15] German Ctr Lung Res DZL, Airway Res Ctr North ARCN, Pulm Res Inst, LungenClin Grosshansdorf, Grosshansdorf, Germany
来源
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 2021年 / 16卷
基金
英国医学研究理事会;
关键词
COPD; disease exacerbation; hospitalisation; patient care; consensus development; expert opinion; OBSTRUCTIVE PULMONARY-DISEASE; PSORIATIC-ARTHRITIS; MORTALITY; OUTCOMES; COST;
D O I
10.2147/COPD.S287705
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Despite hospitalization for exacerbation being a high-risk event for morbidity and mortality, there is little consensus globally regarding the assessment and management of hospitalised exacerbations of COPD. We aimed to establish a consensus list of symptoms, physiological measures, clinical scores, patient questionnaires and investigations to be obtained at time of hospitalised COPD exacerbation and follow-up. Methods: A modified Delphi online survey with pre-defined consensus of importance, feasibility and frequency of measures at hospitalisation and follow-up of a COPD exacerbation was undertaken. Findings: A total of 25 COPD experts from 18 countries contributed to all 3 rounds of the survey. Experts agreed that a detailed history and examination were needed. Experts also agreed on which treatments are needed and how soon these should be delivered. Experts recommended that a full blood count, renal function, C-reactive protein and cardiac blood biomarkers (BNP and troponin) should be measured within 4 hours of admission and that the modified Medical Research Council dyspnoea scale (mMRC) and COPD assessment test (CAT) should be performed at time of exacerbation and follow-up. Experts encouraged COPD clinicians to strongly consider discussing palliative care, if indicated, at time of hospitalisation. Interpretation: This Europe-wide consensus document is the first attempt to standardise the assessment and care of patients hospitalised for COPD exacerbations. This should be regarded as the starting point to build knowledge and evidence on patients hospitalised for COPD exacerbations.
引用
收藏
页码:321 / 332
页数:12
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