Exacerbation and recovery process in chronic obstructive pulmonary disease

Background: Exacerbations due to chronic obstructive pulmonary disease (COPD) negatively affect the prognosis and clinical status of the disease. We aimed to investigate the factors that may be associated with exacerbation and recovery period in chronic obstructive pulmonary disease (COPD). Methods: This study was performed on patients hospitalized for exacerbation of COPD over 40 years of age between January 2016 and January 2018. Patients with concomitant asthma-COPD overlap syndrome, bronchiectasis or interstitial lung disease, pneumonia, obstructive sleep apnea syndrome, lung malignancy were excluded from the study. The duration up to 2 days in the absence of symptoms was considered to be a recovery period. Patients were evaluated daily during hospital stay during hospital stay; After discharge, the patients were questioned and recorded by phone call with 2 days intervals. Body mass index, smoking history, accompanying comorbidities, HADS (Hospital Anxiety And Depression Scale) score, presence of concomitant chronic bronchitis, CAT score, mMRC score, GOLD stage, number of exacerbation in previous year, drugs used, exacerbation type, blood gas analysis, spirometric values, recovery period, need for non-invasive mechanical ventilation, sputum culture, antibiotic use, systemic steroid use, mortality, inhaler compliance were evaluated. Results: The study included a total of 29 patients, 22 (75,86%) of which were men. The mean age of the patients was 67.86±10,58 years. The mean FEV1 was 37,00%±15,62. Seventeen patients (58,62%) were in stage D. There were 4 patients (13,79%) who had no exacerbation, 7 patients (24,14%) who had 1 exacerbation and 18 patients (62,07%) who had 2 or more exacerbation history in previous year. Patients with GOLD stage D were significantly more likely to have 2 or more exacerbations (94,12%) in previous year compared to other stages (p <0.001). The mean recovery period was 20.93±12,08 days. The recovery period was significantly longer in patients who had a history of 2 or more exacerbations (24.8±13.2 days) than patients who had no history of exacerbation (11.0±6.0 days) in previous year (p=0.031). In addition, there was a moderate positive correlation between recovery time and CAT score (p=0.023). No significant correlation was found between recovery time and age, BMI, smoking, spirometric parameters, blood gas analysis parameters, antibiotic and steroid use, duration of hospitalization (day), and hospital anxiety and depression scale score. Conclusions: This study showed that COPD exacerbation and recovery period were associated with exacerbation history in the previous year and patients' CAT scores. Key Words: COPD, Exacerbation, Recovery