PT  - JOURNAL ARTICLE
AU  - Mariaenrica Tine
AU  - Graziella Turato
AU  - Kim Lokar Oliani
AU  - Erica Bazzan
AU  - Umberto Semenzato
AU  - Davide Biondini
AU  - Matteo Bonato
AU  - Marina Saetta
AU  - Manuel G. Cosio
TI  - Acute exacerbation of COPD in Emergency Room: just COPD exacerbations?
AID  - 10.1183/13993003.congress-2019.PA5220
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA5220
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA5220.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA5220.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - 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.FootnotesCite 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).