The inclusion criteria were: (1) adults >18 years old, (2) known COPD based on medical history or spirometry tests, (3) admission to internal medicine department, and (4) AECOPD as the main diagnosis given to the patient at discharge with at least one relevant symptom including increased dyspnea, sputum, or cough. We included both cohorts to better represent AECOPD hospitalizations on a national scale. The study was approved by each institutional ethical committee. The current survey is based on two cohorts, one retrospective ( n = 1,166) and one prospective ( n = 344). In this manuscript, we describe its results and comparison with the recommended care by the main guidelines.ĬOPDIS is a survey of patients with AECOPD, who were admitted to 40 internal medicine departments in 13 medical centers across Israel between 20. Our aim was to evaluate the pre-admission, in-hospital, and pre-discharge management of patients with AECOPD on a national scale, with reference to the GOLD guidelines, in order to raise awareness and possibly lead to a change in health policy.įor this purpose, we conducted the Chronic Obstructive Pulmonary Disease Israeli Survey (COPDIS), a national multicenter survey aimed to evaluate the routine care of patients with AECOPD hospitalized at internal medicine departments in Israel. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are the reference for the standard of care in most hospitals and respiratory clinics in Israel. There are no domestic accepted guidelines for the care of AECOPD patients in Israel. We hypothesized that similar gaps exist in the care of AECOPD before and during their hospitalization at the internal medicine departments in Israel.
Furthermore, exacerbations are the primary cause of hospital admissions and account for 40–75% of COPD’s total health care costs ( 7, 8).Īlthough guidelines and standard of care recommendations have been published ( 3, 5, 9), there are still gaps in the treatment of AECOPD in internal medicine departments, where most of these patients are hospitalized ( 10–12). The most relevant events affecting COPD mortality are acute exacerbations (AECOPD), as their frequency and severity are significant modifiers for management and outcomes ( 3, 5, 6). Comorbidities, such as heart failure and diabetes mellitus, are frequent among COPD patients and significantly impact their quality of life, exacerbation frequency and survival ( 3, 4). Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide with an increased rate despite health care efforts, financial costs and research ( 1, 2).
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