Acute exacerbation of COPD: is it the “stroke of the lungs”?

Figures & data

Figure 1 Fletcher–Peto diagram modified: lung function decline is not a constant, stable process.

Notes: It is the accumulated result of mild losses during steady state and sharp losses, due to acute exacerbations that accelerate as exacerbations become more frequent and more severe over time, during the natural course of the disease.
Abbreviations: AECOPD, acute exacerbation of chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 second; HrQoL, health-related quality of life.

Table 1 Similarities in the catastrophic pathophysiologic cascade triggered by acute myocardial infarctions and acute COPD exacerbations

Diseases	More symptoms	Higher hospitalization rates	Lower quality of life	Lower exercise capacity	Poorer prognosis
Coronary disease (myocardial infarctions)	√^Citation30	√^Citation31	√^Citation32	√^Citation31	√^Citation33
COPD (acute exacerbation)	√^Citation14, ^Citation15	√^Citation35, ^Citation36	√^Citation37	√^Citation34	√^Citation38, ^Citation39

Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 2 AECOPD is the “stroke of the lungs”.

Abbreviation: AECOPD, acute exacerbation of chronic obstructive pulmonary disease.

AdabagASTherneauTMGershBJWestonSARogerVLSudden death after myocardial infarctionJAMA20083002022202918984889

 PubMed Web of Science ®Google Scholar

ChaudhrySIKhanRFChenJNational trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999–2010J Am Heart Assoc201435e00119725249298

 PubMed Web of Science ®Google Scholar

HawkesALPatraoTAWareRAthertonJJTaylorCBOldenburgBFPredictors of physical and mental health-related quality of life outcomes among myocardial infarction patientsBMC Cardiovasc Disord2013136924020831

 PubMed Web of Science ®Google Scholar

ZamanSKovoorPSudden cardiac death early after myocardial infarction: pathogenesis, risk stratification, and primary preventionCirculation2014129232426243524914016

 PubMed Web of Science ®Google Scholar

KannerREAnthonisenNRConnettJELower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild obstructive pulmonary disease: Results from the lung health studyAm J Respir Crit Care Med200116435836411500333

 PubMed Web of Science ®Google Scholar

DonaldsonGCSeemungalTARBhowmikAWedzichaJARelationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary diseaseThorax20025784784512324669

 PubMed Web of Science ®Google Scholar

DewanNARafiqueSKanwarBAcute exacerbations of COPD. Factors associated with poor treatment outcomesChest200011766267110712989

 PubMed Web of Science ®Google Scholar

Garcia-AymerichJMonsóEMarradesRMRisk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation. EFRAM studyAm J Respir Crit Care Med20011641002100711587986

 PubMed Web of Science ®Google Scholar

SeemungalTADonaldsonGCPaulEABestallJCJeffriesDJWedzichaJAEffect of exacerbation on quality of life in patients with chronic obstructive pulmonary diseaseAm J Respir Crit Care Med1998157141814229603117

 PubMed Web of Science ®Google Scholar

DonaldsonGCWilkinsonTMHurstJRPereraWRWedzichaJAExacerbations and time spent outdoors in chronic obstructive pulmonary diseaseAm J Respir Crit Care Med200517144645215579723

 PubMed Web of Science ®Google Scholar

Soler-CataluñaJJMartínez-GarcíaMARomán SánchezPSalcedoENavarroMOchandoRSevere acute exacerbations and mortality in patients with chronic obstructive pulmonary diseaseThorax2005601192593116055622

 PubMed Web of Science ®Google Scholar

Domingo-SalvanyALamarcaRFerrerMHealth-related quality of life and mortality in male patients with chronic obstructive pulmonary diseaseAm J Respir Crit Care Med200216668068512204865

 PubMed Web of Science ®Google Scholar