Chest
Original ResearchCOPDCharacterizing and Quantifying the Symptomatic Features of COPD Exacerbations
Section snippets
Study Design and Participant Recruitment
A total of 23 potential items were developed from a comprehensive series of interviews and qualitative analyses in patients with COPD.11 These items assessed patients' breathlessness, cough, sputum, chest discomfort, difficulty breathing, activity limitations, feelings of tiredness or weakness, sleep disturbance, and scared or worried feelings about their condition. Patients completed the diary each evening before bedtime, reflecting back on “today” and rating the severity of each attribute or
Sample
There were 222 acute patients and 188 stable patients. Their mean ± SD age was 65 ± 10 years, and 48% were men. Stable-state FEV1 was 51% predicted ± 20% predicted. Using independent sample t tests for continuous variables and χ2 tests for categorical variables, there were no significant differences between the groups on any demographic or clinical characteristics with two exceptions. The acute group reported more frequent events the previous year (2.2 ± 0.5) than the stable group (1.3 ± 1.2) (t
Discussion
This study identified a set of symptoms (14 items) that characterize an exacerbation of COPD, including breathlessness, chest tightness, chest congestion, cough, sputum production, chest discomfort, feeling weak or tired, sleep disturbance, and feeling scared or worried. No items performed differently between the stable and exacerbation conditions, and none appeared to be uniquely characteristic of an exacerbation. Sputum purulence or color—the item most expected to differ between states10—was
Acknowledgments
Author contributions: Dr Jones: contributed to the study design, data analysis, and writing of the manuscript.
Dr Chen: contributed to the data analysis and writing of the manuscript.
Dr Wilcox: contributed to the analyses, report preparation, and the development of content for the manuscript.
Dr Sethi: contributed to the study design, data analysis, and writing of the manuscript.
Dr Leidy: contributed to the study design, execution, data analyses, report preparation, and writing of the manuscript.
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Funding/Support: The following companies have provided unrestricted funds to support the EXACT-PRO Initiative: AstraZeneca, GlaxoSmithKline, Pfizer Inc, Boehringer Ingelheim, Merck & Company, Sepracor Inc, Forest Laboratories Inc, Novartis, Schering-Plough, Adams Respiratory Therapeutics, Bayer, Atlanta AG (Nycomed), and Ortho-McNeil.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).
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A list of study group members is available in e-Appendix 1.