Patients hospitalized for COPD have a high prevalence of modifiable risk factors for exacerbation (EFRAM study)

There is little information available concerning the extent to which chroni c obstructive pulmonary disease (COPD) patients are satisfactorily managed, especially, regards factors supposedly related to COPD exacerbation. The p resent study assessed the prevalence rates of potentially modifiable risk f actors of COPD exacerbation in patients hospitalized for this reason. A systematic sample of one out of two patients admitted for COPD exacerbati on, during 1 yr, in four tertiary hospitals in the Barcelona area, Spain, w as performed. Patients answered a questionnaire and underwent anthropometri c measurements, spirometric tests and arterial blood gas sampling. Prevalen ce rates and 95% confidence intervals (95% CI) for risk factors were obtain ed, and the generalized estimating equation (GEE) method was used to allow for patients to provide information on different admissions. The study recruited 353 patients (29 female) with a total of 404 admissions age (mean+/-SD) 69+/-9, median forced expiratory volume in one second (FEV 1) 31% of predicted and mean partial pressure of oxygen (PO2) 63+/-13 mmHg. Of these, 28% had not received an influenza vaccination; a high number (86 %) did not attend rehabilitation programmes; 28% of patients with PO2 less than or equal to 55 mmHg were not using long-term oxygen therapy (LTOT); am ong LTOT users, 18% used it <15 h a day; 43% of the total failed in some of the essential inhaler manoeuvres; 26% were current smokers; 21% of noncurr ent smokers were exposed to passive smoking at home; current occupational e xposure was low (5%). In summary, the authors found a moderate to high prevalence of potentially modifiable risk factors in a large representative sample of patients hospit alized for a chronic obstructive pulmonary disease exacerbation, suggesting unsatisfactory features in their management.