Abstract
Background: Severe exacerbations of COPD (AECOPD) often require Emergency Room (ER) visits and hospitalization. Because multimorbidities in smokers are frequent, their aggravation may contribute to the acute respiratory symptoms making the causative diagnosis of AE in ER difficult.
Aim: To analyse the ER diagnosis in smokers presenting with respiratory AE and assess the factors influencing its accuracy when comparing with post-hospitalization diagnosis.
Methods: 119 smokers (age 74±10) presenting to ER for acute worsening of respiratory symptoms were diagnosed of: AECOPD, AECOPD and heart failure (AECOPD+HF) and Other acute events and admitted to a Respiratory Ward (RW). Discharge diagnosis, obtained after complete evaluation, was then compared with ER diagnosis. Usefulness of WBC, PCR, BNP and ABG to diagnosis was assessed.
Results: At RW discharge: AECOPD was diagnosed in 40% of cases, of which 69% had correct ER diagnosis; AECOPD+HF was diagnosed in 40%, of which 25% ER correct; and Other acute events in 20%, of which 57% ER correct. The RW final diagnosis by GOLD stage and the % of corresponding correct ER diagnosis are shown in figure. Importantly 58% of GOLD 1 had AECOPD+HF. Low BNP and PCR would favor AECOPD diagnosis (p<0.01).
Conclusions: In a real-life scenario, ER diagnosis of the cause of acute exacerbations in smokers is difficult. A component of heart failure could be present in about 50% of cases, especially in GOLD 1.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5220.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019