Celli et al reported criteria for an exacerbation of chronic obstructive pulmonary disease (COPD). The authors are from multiple institutions in North America and Europe.
Criteria for an exacerbation of COPD:
(1) patient with COPD
(2) occurrence of an event with dyspnea, cough and/or sputum production
(3) worsens over a period <= 14 days
(4) variable tachypnea and/or tachycardia
(5) often associated with evidence of local and systemic inflammation
Features:
(1) an episode can be life-threatening
(2) requires a complete and thorough clinical assessment
(3) requires exclusion of other conditions that can explain the symptoms, such as pneumonia, heart failure or pulmonary embolism
(4) the cause for the event (infection, environmental exposure, etc) should be identified
Evaluation may include:
(1) vital signs
(2) sputum assessment (volume, color, etc)
(3) signs of respiratory distress such as use of accessory muscles
(4) pulse oximetry
(5) laboratory tests for serum CRP, serum creatinine and white blood cell count
(6) arterial blood gases if severe
