Optimizing Management of Exacerbations and Premature Death Risks in Patients with COPD (Review)

Abstract

Data analysis of numerous studies was carried out and trends and directions in the management of patients with сhronic obstructive pulmonary disease (COPD) were analysed. Studying the characteristics of factors contributing to disease development без коми allows us to understand that the smoking epidemic, the aging of the world population and the lack of disease-modifying therapy will lead to a further increase in mortality from COPD. Each COPD exacerbation increases both the risk and frequency of subsequent exacerbations, and the development of local or systemic changes and complications has also been established. Not only severe but also moderate COPD exacerbations (those that do not require hospitalization and could be treated on an outpatient basis) also increased the risk of subsequent exacerbations and death. The degree of increase in risk was proportional to the number of exacerbations per year. Thus, two moderate exacerbations per year increased the risk of death by 80 % (hazard ratio — 1.80 (95 % confidence interval (CI): 1.19—2.70)), while increased frequency of exacerbations to 5 increased the hazard ratio to 2.33 (95 % CI: 1.45—3.76).