The role of exhaled nitric oxide in predicting re-visit of copd exacerbated patients

Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible. Many COPD patients come back to ED or primary physicians for worsening of COPD symptoms within two weeks of their initial visit of ED. This situation is called relapse. The determinants of relapse in the literature have shown conflicting and sparse results. Studies on e-NO measurement in COPD patients have shown conflicting results. Several studies have demonstrated high level of e-NO in COPD patients while some others have not demonstrated high levels of e-NO compared to controls. The aim of the present study was to characterize ED use of patients with COPD and to determine the role of e-NO in predicting the relapse of COPD exacerbated patients in the ED. This is a prospective cohort study on patients with exacerbated COPD in an ED. Data of 28 revisit versus 64 no revisit, a total of 92 patients variables were compared. We didn?t find a relation between e-NO level and relapse in COPD exacerbated patients. Mean respiratory rate at presentation, home oxygen therapy, home nebulizator therapy, antibiotics prescribed upon discharge, abnormal chest x-ray and the number of ED visits in the previous year were associated with increased risk of revisit in univariate analysis. However, after multivariate analysis, Mean respiratory rate at presentation (OR: 1.11; 95% CI: 1.09-1.21) and antibiotics prescribed upon discharge (OR: 0.22; 95% CI: 0.05-0.94) were stil significant. In our study, there was no relation between e-NO level and relapse in COPD exacerbated patients