[Comprehension and recognition of acute exacerbation among chronic obstructive pulmonary disease patients]

The aim of the study was to gain insight of comprehension and recognition on the exacerbations and related factors of chronic obstructive pulmonary disease(COPD), so as to provide evidence for treatment on acute exacerbations of COPD(AECOPD).

A cross-sectional, interview-based survey was carried. Pulmonary function tests were conducted in patients with COPD between January and December 2010 in Guangzhou.

1) Questionnaires on 911 COPD patients were available, with a efficient rate as 94.6% (911/963)including 738 men (81.0%)and 173 women(19.0%), with mean age as 69.2 years old (± 9.1 years). Patients with COPD were 31(3.4%), 363 (39.8%), 340(37.3%)and 177(19.4%)at stages I , II, III, IV respectively, with 60.8% (554/911)were exacerbation. The mean index for smoking was 45.6 pack/year(±25.0). 2)Only 573 patients were aware of COPD and 50.4% (459/911)patients had never heard of AECOPD. Among 452 patients who had heard of AECOPD, 87.2%, 59.1%, 30.5% and 33.4% of them viewed that the exacerbation of COPD were mainly characterized as:increasing status on short of breath, increasing amount on sputum, purulent sputum or coughing. When exacerbation occurred, 87.6% of the patients would recognize the signs, with 75.4% of the patients would go to the outpatient clinic. The mean VAS scores on the occurrence of next exacerbations were 37.9(±19.7). 3)753 (82.7%) patients had been tested for pulmonary function, but only 30.5% of them were aware of the results. 523(69.5%)patients were previously diagnosed with COPD, with an average course of 7 years. Among the 452 patients who had heard of AECOPD before the onset of disease, the mean time of exacerbation in the past 1 year was 4.3, and the mean time of ending up at either outpatient or inpatient medical settings was 4.8. The average duration of exacerbation and time of recovery was 1.84 and 3.09 weeks. Duration of stable state between the 2 exacerbation episodes was 13.17 weeks. 4)Among 911 patients, only 10.3% of them were aware of the worsening condition. 21.0% recognized of the greater susceptibility to the disease and 58.4% believed that their health gradually deteriorating. More seen among patients under exacerbation than those who were stable. Among 452 patients who had heard of AECOPD before, most of them(83.2%)thought that exacerbation affected their working condition and daily activities, while up to 91.6% of them thought that their social events were also negatively affected. Exacerbation also caused negative emotions as depression, anxiety, and anger. 5)After adjusted for age, occupation, smoking status and index, factors as:sex, education level, economic situation, and stage of COPD were found affecting the AECOPD cognitive, from data under multivariate logistic regression analysis.

Patients with COPD were poor on the awareness of AECOPD, particularly among patients with low income, low education levels, low income or at low COPD stage.