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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Risk factors for poor outcomes in patients with acute COPD exacerbations

Risk factors for poor outcomes in patients with acute COPD exacerbations
  • Comorbid conditions (especially heart failure or ischemic heart disease)
  • Severe underlying COPD (eg, FEV1 <50%)
  • Frequent exacerbations of COPD (ie, ≥2 exacerbations per year)
  • Hospitalization for an exacerbation within the past 3 months
  • Receipt of continuous supplemental oxygen
  • Age ≥65 years*
Patients with greater underlying COPD severity are at higher risk for poor outcomes if initial antibiotic therapy is inadequate. We thus use a broader empiric regimen for such patients.
COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 second.
* Older age (eg, age ≥65 years) is also associated with poorer outcomes and/or risk of infection with drug-resistant pathogens. While not a strict indication for broadening antibiotic therapy, we consider older age as additive to the risk factors listed above.
References:
  1. Balter MS, La Forge J, Low DE, et al. Canadian guidelines for the management of acute exacerbations of chronic bronchitis. Can Respir J 2003; 10 Suppl B:3B.
  2. Miravitlles M, Murio C, Guerrero T. Factors associated with relapse after ambulatory treatment of acute exacerbations of chronic bronchitis. DAFNE Study Group. Eur Respir J 2001; 17:928.
  3. Wilson R, Jones P, Schaberg T, et al. Antibiotic treatment and factors influencing short and long term outcomes of acute exacerbations of chronic bronchitis. Thorax 2006; 61:337.
  4. Garcia-Vidal C, Almagro P, Romaní V, et al. Pseudomonas aeruginosa in patients hospitalised for COPD exacerbation: a prospective study. Eur Respir J 2009; 34:1072.
  5. Parameswaran GI, Sethi S. Pseudomonas infection in chronic obstructive pulmonary disease. Future Microbiol 2012; 7:1129.
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