COPD exacerbations: Major events in the course of the disease

Exacerbations of chronic obstructive pulmonary disease (COPD) lead to significant mortality, morbidity and healthcare expenditure globally. COPD exacerbations are heterogenous events; triggers and risk factors include respiratory infections, air pollution and co-morbidities. Exacerbations have an important effect on disease progression through their effect on lung function decline and functional impairment. In turn, these factors increase the susceptibility to the risk factors for exacerbations, thus leading to a cycle of exacerbations. Rigorous prevention and treatment of exacerbations is needed to break this cycle and achieve the goal of exacerbation-free COPD.