Particularities of COPD exacerbations in different phenotypes of the disease in Tunisia

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Published Aug 16, 2016
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Vol. 94 No. 3 (2016): Issue Mar 2016

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Ines Zendah
Khadija Ayed
Hamida Kwas
Amel Khattab
Habib Ghédira

Abstract

Abstract


Background


Chronic Obstructive Pulmonary Disease is defined by a limitation of airflow. This disease is characterized by exacerbations that threaten the patient’s life and worsens his prognosis.

Moreover, COPD patients are different according to many parameters that define different phenotypes. Characteristics of exacerbations may depend on these phenotypes according to few recent studies.

Aim


To determine the characteristics and the prognosis of the exacerbations in each phenotype of COPD patients phenotype in Tunisia.

Methods


Retrospective study including 153 male patients hospitalized for COPD exacerbation from January 2009 to June 2012. Patients were classified into 4 phenotypes according to Burgel’s classification.

Results:


Patients were divided into four phenotypes: phenotype (PH)1: (n=68), PH2: (n=33), PH3: (n=25) and PH4: (n=27). Mean age for PH1, 2, 3 and 4 was: 61, 74, 56 and 72 years. The number of exacerbations per year was higher in PH1. Dyspnea was more important in PH1 and 4. Hypercapnia on admission was higher in PH4. Non invasive ventilation and transfer to resuscitation unit were more frequently mandatory in PH3 and 4.
 
Death occurred 2% of PH1 and 5% of PH4. Hospitalization duration was more important in PH4.

Conclusion

COPD patients are heterogenous and belong to different phenotypes. The characteristics of the exacerbations and their prognosis widely differ according to these different groups. In Tunisia, it seems that patients who had moderate respiratory functional tests impairment are the lowest responders to treatment with a higher frequency of resuscitation unit transfer.

Keywords:

COPD, exacerbation, phenotype, prognosis

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