Chronic Obstructive Pulmonary Disease Exacerbations
It is now recognized that exacerbations are a major cause of the global morbidity
and mortality associated with chronic obstructive pulmonary disease (COPD).
They are also a cause of hospital admission and readmission and thus lead to
considerable health care costs.
Following the observation in the late 1990s that
exacerbations are an important determinant of health-related quality of life in
COPD, there has been considerable interest in the study of exacerbations. Over
the last few years, studies have shown that exacerbations contribute to disease
progression and mortality and that they are an important outcome for new
therapies in COPD.
For this book, we have assembled international experts, both clinicians and
scientists with an interest in COPD exacerbations, to review critically the current
literature and provide up-to-date reviews on the various issues as well as highlight
the many controversies and bottlenecks in the study of exacerbations.
COPD exacerbations are episodes of worsening of symptoms, accompanied
by inflammatory and physiological changes. In this book, we have firstly covered
issues of definition, diagnosis, and epidemiology and then presented a number of
chapters on the many diverse mechanisms, including the role of bacterial and viral
infection to the development of respiratory failure, associated with COPD
exacerbations, which are heterogeneous events. It is now recognized that systemic
inflammation and comorbidity play a prominent role in COPD and affect exacerbation
outcome. Environmental issues, including air pollution, are difficult to
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