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European expert consensus on assessment and management of hospitalised exacerbations of COPD (CICERO ERS CRC)

Sanjay Ramakrishnan, Wim Janssens, Pierre Regis Burgel, Marco Contoli, F M E Franssen, Neil Greening, Timm Greulich, Iwein Gyselinck, Arturo Huerta, Jennifer Quint, Lowie Van Fleteren, Henrik Watz, Mona Bafadhel
European Respiratory Journal 2020 56: 4916; DOI: 10.1183/13993003.congress-2020.4916
Sanjay Ramakrishnan
1Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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  • For correspondence: sanjay.ramakrishnan@ndm.ox.ac.uk
Wim Janssens
2Department of Respiratory Diseases, UZ Leuven, Research group BREATHE, KU Leuven, Leuven, Belgium
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Pierre Regis Burgel
3Faculty of medicine, Paris Descartes, CPSC, Paris, France
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Marco Contoli
4University of Ferrara, Department of Medical Sciences, Ferrara, Italy
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F M E Franssen
5Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
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Neil Greening
6NIHR Leicester Biomedical Research Centre (Respiratory), Glenfield Hospital, Leicester, United Kingdom
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Timm Greulich
7Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University, Member of the German Centre for Lung Research (DZL), Marburg, Germany
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Iwein Gyselinck
2Department of Respiratory Diseases, UZ Leuven, Research group BREATHE, KU Leuven, Leuven, Belgium
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Arturo Huerta
8IDIBAPS August Pi i Sunyer Biomedical Research Institute , Barcelona, Spain
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Jennifer Quint
9National Heart & Lung Institute, Imperial College, London, United Kingdom
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Lowie Van Fleteren
10Department of Internal Medicine and Clinical Nutrition at Institute of Medicine, SU Sahlgrenska, Göteborg, Sweden
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Henrik Watz
11Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshandorf, Germany
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Mona Bafadhel
1Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Abstract

Introduction: Despite being a high-risk event for morbidity and mortality, there is little consensus globally regarding the assessment and management of hospitalised exacerbations of COPD.

Objectives: To find a consensus list of symptoms, physiological measures, clinical scores, patient questionnaires and investigations to be obtained at time of hospitalised COPD exacerbation and follow up.

Methods: A modified online Delphi survey of importance, feasibility and suggested frequency on Likert scales was undertaken. Consensus and stability criteria were pre-defined.

Results: 25 experts from 19 European countries participated. After completion of 2 rounds, consensus was achieved on 642 items (82%). Experts achieved consensus quickly on history and physical examination items. There was less consensus on other items. For example (see table 1), many scores and questionnaires were not considered essential in clinical practice. Experts could not agree on pulmonary function tests to perform routinely at time of hospitalisation nor the importance or frequency in which to perform echocardiography, CT scan and pulmonary function tests at follow-up. Experts could not agree on duration of treatment

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Table 1

Consensus items for clinical scores and questionnaires at time of COPD exacerbation

Conclusion: Despite being a major health burden, hospitalised COPD exacerbations are assessed and managed variably across Europe. Standardisation could impact clinical outcomes.

Acknowledgements: This work was undertaken as part of the CICERO ERS clinical research collaborative.

  • Nursing care
  • COPD - management
  • COPD - exacerbations

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4916.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

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 2020
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European expert consensus on assessment and management of hospitalised exacerbations of COPD (CICERO ERS CRC)
Sanjay Ramakrishnan, Wim Janssens, Pierre Regis Burgel, Marco Contoli, F M E Franssen, Neil Greening, Timm Greulich, Iwein Gyselinck, Arturo Huerta, Jennifer Quint, Lowie Van Fleteren, Henrik Watz, Mona Bafadhel
European Respiratory Journal Sep 2020, 56 (suppl 64) 4916; DOI: 10.1183/13993003.congress-2020.4916

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European expert consensus on assessment and management of hospitalised exacerbations of COPD (CICERO ERS CRC)
Sanjay Ramakrishnan, Wim Janssens, Pierre Regis Burgel, Marco Contoli, F M E Franssen, Neil Greening, Timm Greulich, Iwein Gyselinck, Arturo Huerta, Jennifer Quint, Lowie Van Fleteren, Henrik Watz, Mona Bafadhel
European Respiratory Journal Sep 2020, 56 (suppl 64) 4916; DOI: 10.1183/13993003.congress-2020.4916
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