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Recent Advances in Chest Medicine |

Preventing Acute Exacerbations and Hospital Admissions in COPDPreventing Acute Exacerbations of COPD

Nathaniel Marchetti, DO, FCCP; Gerard J. Criner, MD, FCCP; Richard K. Albert, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Drs Marchetti and Criner), Department of Medicine, Temple University School of Medicine, Philadelphia, PA; and Department of Medicine (Dr Albert), Denver Health and the University of Colorado - Denver, Denver, CO.

Correspondence to: Nathaniel Marchetti, DO, FCCP, 3401 N Broad St, Philadelphia, PA 19140; e-mail: nathaniel.marchetti@tuhs.temple.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(5):1444-1454. doi:10.1378/chest.12-1801
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COPD is a leading cause of morbidity and mortality worldwide and is now the third leading cause of death in the United States. Acute exacerbations of COPD (AECOPDs) are common events that often lead to hospitalization, and their frequency worsens with disease progression. AECOPDs are associated with worsened quality of life, increased health-care costs, and increased mortality. Accordingly, there is great interest in preventing AECOPDs to improve outcomes. Both pharmacologic and nonpharmacologic interventions alter the frequency of AECOPDs and COPD-related hospitalizations. To examine the best available evidence, we restricted this review to include studies that used randomized controlled designs lasting at least 6 months. Pharmacologic interventions discussed include inhaled corticosteroids, long-acting β-agonists, long-acting antimuscarinic agents, macrolide antibiotics, and phosphodiesterase-4 inhibitors. The nonpharmacologic interventions discussed include lung volume reduction surgery, pulmonary rehabilitation, and disease management programs.

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