Spanish COPD guidelines (GesEPOC): hospital diagnosis and treatment of COPD exacerbation

作者：Jose Soler Cataluna Juan; Pinera Salmeron Pascual; Antonio Trigueros Juan; Calle Myriam; Almagro Pere; Molina Jesus; Antonio Quintano Jose; Antonio Riesco Juan; Simon Adolfo; Soriano Joan B; Ancochea Julio; Miravitlles Marc

来源：Emergencias, 2013, 25(4): 301-317.

• Chronic obstructive pulmonary disease
• Inpatients
• treatment
• Exacerbation

Exacerbations of chronic obstructive pulmonary disease (COPD) generate significant morbidity and mortality, increasing the health care burden and raising costs, particularly when hospital admission is required. Applying high-quality evidence-based methods to attenuate the impact of exacerbations is therefore a high priority. The Spanish COPD Guidelines (GesEPOC) provide recommendations on the diagnosis and treatment of patients with exacerbated COPD requiring hospital care. New definitions are proposed in the interest of differentiating a new COPD exacerbation from therapeutic failure, relapse, and related concepts. The guidelines propose a 3-step diagnostic process: 1) establish the diagnosis of COPD exacerbation; 2) assess its severity, and 3) establish the etiology. For emergency department management of the exacerbation, the guidelines set out 4 phases: 1) admission and classification; 2) treatment; 3) observation to monitor clinical course; and 4) resolution of the crisis, with orientation of future care and transfer or discharge. GesEPOC also makes recommendations for care of the admitted patient, including admission and discharge criteria as well as follow-up protocols according to clinical phenotype. Finally, quality-of-care standards are discussed along with specific quality indicators that can be helpful for monitoring the care process and improving outcomes.

• 出版日期2013-8