Ahmed Ben Saad

Heterogeneity inside group D COPD patients: About 827 cases

Aims: to investigate the agreement of Airflow Limitation9s classification (GOLD3-4), number of acute exacerbations (AE) and hospitalisation (H) for AE/year when classifying patients into group D in terms of the severity of the disease and evolution. Methods: A retrospective single-centre study of GOLD D COPD patients followed over a period of 24 years (1990-2014). We distinguished 3 subgroups. DI:1 criterion (GOLD3-4 or AE≥2/year or 1H due to AE;85 cases,10%), DII:2 criteria (213 cases,26%) and DIII: 3 criteria (529, 64%). Results: The study included 827 group D COPD patients (97% male; mean age 68+/-9 years). The increase of the number of criteria is associated with the decrease of the BMI (DI:25.6, DII:24.6, DIII:23.5 kg/m 2 ;p=0.005), the forced vital capacity (2.22, 1.86, 1.53L; p 1 (1.51, 1.21, 0.9; p 1 decline (40.5, 51.6, 64ml/year; p Conclusion: The increase of the number of criteria of classification in COPD group D is associated with a severe deterioration of lung function with frequent H and poor outcomes.

Predictive factors of 90-days post-discharge COPD acute exacerbation's recurrence

Aims: To determine the predictive factors of acute exacerbation (AE) occurring within 90 days of discharge for AECOPD. Methods: We retrospectively studied patients with AECOPD admitted to our hospital between 1990 and 2014. We compared 2 groups of patients: G1: patients who had an AECOPD within 90 days post hospital-admitted COPD exacerbations (299 cases,27%); G2: AE›90 days of discharge (820 cases,73%). Results: The study included 1119 COPD patients (mean age 67±10years, 97%males). Patients of G1 are more symptomatic than G2 (mMRC≥2: 78% vs 59% in G2,p 1 (1.05-1.2L,p 1 decline (65 vs 56 ml/year,p=0.018), a higher number of AE/year with more hospitalisations (H) in pulmonary department and ICU (p Conclusions: Severe deterioration of lung function, anemia, past history of severe AE, need for ventilatory support and Pyocyanic AE were identified as the most predictive factors for early recurrence of AE after H and are associated with poor prognosis.