BACKGROUND: Epidemics of hospitalization for chronic obstructive pulmonary disease (COPD) occur annually during the Christmas holidays, and COPD exacerbations commonly coincide with respiratory viral infections. OBJECTIVE: To compare the incidence and determinants of COPD exacerbations occurring between the Christmas holiday period and the remainder of the winter season. METHODS: Seventy-one subjects with COPD of mixed severity faxed daily symptom diaries to a computer monitoring system from December 1, 2006, to April 30, 2007. Possible exacerbations prompted a home visit for assessment, spirometry and specimen collection for virological testing. RESULTS: Study subjects submitted a total of 95.4% of possible daily symptom diary sheets by fax. Of 114 possible COPD exacerbations detected using the faxed diaries, 110 met the Anthonisen criteria for true exacerbations. A total of 47 exacerbations (mean 6.7/week) occurred during the Christmas holiday period, while 63 exacerbations (mean 4.3/week) occurred during the remainder of winter. Of the Christmas period exacerbations and of those in the balance of winter, 21 (44%) and 20 (32%), respectively, coincided with respiratory viral infections. CONCLUSIONS: The incidence of COPD exacerbations during the Christmas period was greater than during the rest of winter in 2006/2007 and peaked immediately before Christmas - in contrast to hospital presentation for COPD, which peaked during the Christmas week. No clear role of respiratory viral infections in the increased rate of exacerbations during the Christmas period was established in the present study. COPD patients were highly compliant with daily symptom reporting using faxed daily diaries, which permitted nearly complete detection of all exacerbations that occurred at incidence.
机构:
Nippon Med Sch, Resp Care Clin, Chiyoda Ku, Tokyo 1020074, Japan
Nippon Med Sch, Grad Sch Med, Dept Pulm Med & Oncol, Tokyo 1020074, JapanNippon Med Sch, Resp Care Clin, Chiyoda Ku, Tokyo 1020074, Japan
Ishii, Takeo
Kida, Kozui
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Nippon Med Sch, Resp Care Clin, Chiyoda Ku, Tokyo 1020074, Japan
Nippon Med Sch, Grad Sch Med, Dept Pulm Med & Oncol, Tokyo 1020074, JapanNippon Med Sch, Resp Care Clin, Chiyoda Ku, Tokyo 1020074, Japan
机构:
SUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
VA Med Res, 151,3495 Bailey Ave, Buffalo, NY 14215 USASUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Sethi, S.
Anzueto, A.
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Univ Texas Hlth Sci Ctr San Antonio, South Texas Vet Hlth Care Syst, San Antonio, TX 78229 USASUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Anzueto, A.
Miravitlles, M.
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Hosp Univ Vall dHebron, Dept Pneumol, CIBER Enfermedades Resp CIBERES, Barcelona, SpainSUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Miravitlles, M.
Arvis, P.
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Bayer HealthCare, Loos, FranceSUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Arvis, P.
Alder, J.
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Bayer HealthCare Pharmaceut, Whippany, NJ USASUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Alder, J.
Haverstock, D.
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Bayer HealthCare Pharmaceut, Whippany, NJ USASUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Haverstock, D.
Trajanovic, M.
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Bayer Inc, Toronto, ON, CanadaSUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
Trajanovic, M.
Wilson, R.
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Royal Brompton Hosp, Host Def Unit, London SW3 6LY, EnglandSUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY 14260 USA
机构:
Univ Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USAUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Bhatt, Surya P.
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Agusti, Alvar
Bafadhel, Mona
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Kings Coll London, Sch Immunol & Microbial Sci, Fac Life Sci & Med, London, EnglandUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Bafadhel, Mona
Christenson, Stephanie A.
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Univ Calif San Francisco, Div Pulm Crit Care Allergy & Sleep Med, San Francisco, CA USAUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Christenson, Stephanie A.
Bon, Jessica
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Univ Pittsburgh, Div Pulm Allergy & Crit Care Med, Pittsburgh, PA USA
VA Pittsburgh Healthcare Syst, Pittsburgh, PA USAUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Bon, Jessica
Donaldson, Gavin C.
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机构:
Imperial Coll London, Natl Heart & Lung Inst, London, EnglandUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Donaldson, Gavin C.
Sin, Don D.
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机构:
Univ British Columbia, Ctr Heart Lung Innovat, Vancouver, BC, Canada
Univ British Columbia, Dept Med, Vancouver, BC, Canada
St Pauls Hosp, Vancouver, BC, CanadaUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Sin, Don D.
Wedzicha, Jadwiga A.
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机构:
Imperial Coll London, Natl Heart & Lung Inst, London, EnglandUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA
Wedzicha, Jadwiga A.
Martinez, Fernando J.
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Weill Cornell Med NewYork Presbyterian Hosp, New York, NY USAUniv Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA