Clinical, functional and biochemical changes during recovery from COPD exacerbations.

Details

Serval ID
serval:BIB_52A451D3C958
Type
Article: article from journal or magazin.
Collection
Publications
Title
Clinical, functional and biochemical changes during recovery from COPD exacerbations.
Journal
Respiratory medicine
Author(s)
Koutsokera A., Kiropoulos T.S., Nikoulis D.J., Daniil Z.D., Tsolaki V., Tanou K., Papaioannou A.I., Germenis A., Gourgoulianis K.I., Kostikas K.
ISSN
1532-3064 (Electronic)
ISSN-L
0954-6111
Publication state
Published
Issued date
06/2009
Peer-reviewed
Oui
Volume
103
Number
6
Pages
919-926
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The pathways underlying chronic obstructive pulmonary disease exacerbations (ECOPD) remain unclear. This study describes the clinical, functional and biochemical changes during recovery from ECOPD. Thirty hospitalized patients with Anthonisen's type-I ECOPD were evaluated on days 0 (admission), 3, 10 and 40. A five-symptom score (TSS), performance status and quality of life were evaluated. Post-bronchodilator spirometry, blood gases, oxidative stress, C-reactive protein (CRP), serum amyloid-A (SAA), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and fibrinogen were also measured. Patients were classified as early- or late-recoverers, based on whether dyspnea had returned to pre-exacerbation level by day 10. Most clinical, functional and biochemical parameters improved during follow-up. CRP and IL-6 levels reduced on Day 3 (p<0.05), whereas SAA on Day 10 (p<0.01). TNF-alpha was reduced on Days 3 and 10, but on Day 40 its levels returned to baseline. Fibrinogen and WBC reduced only by day 40. TSS and dyspnea were correlated inversely with FEV(1) on days 3, 10 and 40. Although late-recoverers had lower FEV(1) on admission, none of the reported measurements on admission and day 3 predicted early recovery. During recovery from ECOPD, symptomatic improvement correlates only with post-bronchodilator FEV(1) whereas systemic inflammatory burden subsidence does not correlate with clinical and functional changes. Although late-recoverers have lower FEV(1) on admission, none of the measured parameters is able to predict early symptomatic recovery.
Keywords
Aged, Biomarkers/metabolism, C-Reactive Protein/metabolism, Disease Progression, Dyspnea/physiopathology, Female, Fibrinogen/metabolism, Forced Expiratory Volume/physiology, Hospitalization, Humans, Interleukin-6/metabolism, Male, Prospective Studies, Pulmonary Disease, Chronic Obstructive/metabolism, Pulmonary Disease, Chronic Obstructive/physiopathology, Pulmonary Disease, Chronic Obstructive/rehabilitation, Quality of Life, Serum Amyloid A Protein/metabolism, Severity of Illness Index, Time Factors, Tumor Necrosis Factors/metabolism, Vital Capacity/physiology
Pubmed
Web of science
Open Access
Yes
Create date
19/07/2019 18:43
Last modification date
21/08/2019 5:32
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