COPD as a Life-Limiting Illness: Implications for Advanced Practice Nurses

Donna M. Goodridge, RN, PhD

Disclosures

Topics in Advanced Practice Nursing eJournal. 2006;6(4) 

In This Article

Acute Exacerbations of COPD

While people with COPD tend to live in an unremitting state of compromised health, periodic exacerbations become increasingly frequent as the disease progresses. Acute exacerbations of COPD (AECOPD) are the most common cause of physician visits, hospital admissions, and death among patients with COPD, and they lead to decreased quality of life and accelerated decline in lung function.[12] Increased sputum volume, increased sputum purulence, and increased dyspnea define this syndrome.[23]

AECOPD often necessitates emergency room visits, with exacerbations occurring as often as 4 times a year.[24] In fact, respiratory admissions accounted for 25% of all acute medical emergency admissions in 1 study from the United Kingdom, with AECOPD accounting for half of these admissions.[25]

Although COPD is characterized by a protracted course, death typically results from sudden complications such as infection, cardiovascular events such as dysrhythmias, or acute respiratory failure.[26,27,28,29] Mortality data are known to underestimate COPD as a cause of death because it is more likely to be cited as a contributory rather than an underlying cause of death.[17] Table 3 describes a profile of COPD patients at risk for death from acute respiratory failure.[12]

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