**Inflammation and the Lung**

**Chapter 4**

**Acute Exacerbations of**

http://dx.doi.org/10.5772/54867

**1. Introduction**

S. Uzun, R.S. Djamin, H.C. Hoogsteden, J.G.J.V. Aerts and M.M. van der Eerden

Additional information is available at the end of the chapter

**Chronic Obstructive Pulmonary Disease**

Chronic obstructive pulmonary disease (COPD) is a disease which is characterized by airway inflammation and progressive airflow limitation with poor reversibility. Patients with COPD can experience periods of acute deterioration, which are called exacerbations. There are different definitions for an acute exacerbation of COPD (AECOPD). A symptom reported AECOPD is defined solely based on a patient's symptoms [1]. This is regardless of whether the patient seeks medical attention or receives treatment for the exacerbation. An event defined AECOPD requires a therapeutic intervention such as a change in COPD medications or a change in healthcare utilization [1]. Generally accepted is the definition as in the guidelines of the World Health Organization, US National Heart Lung and Blood Institute and Global Initiative for Chronic Obstructive Lung Disease (GOLD), which define an exacerbation as "an event in the natural course of the disease characterized by a change in the patient's baseline dyspnoea, cough, and/or sputum that is beyond normal day-to-day variations, is acute in onset and may warrant a change in regular medication in a patient with COPD" [2]. Frequent exacerbations can result in a decreased health related quality of life [3], a decline in lung

function [4], an increased risk of hospitalization [5] and an increase in mortality [6].

COPD and acute exacerbations of COPD (AECOPD) impose a burden on health care and so‐ ciety. It is estimated that COPD is the 4th leading cause of death worldwide and will be the 3rd leading cause of death in 2030 [7]. Along with increasing mortality rates, the loss in disa‐ bility-adjusted life years (DALYs) also rises. By 2030 COPD will be the 5th leading cause of loss in DALYs globally, where it was only number 13 in 2004. Increasing health care costs will be the consequence of this trend. In the European Union COPD accounts for just over 3% of the total health care budget. In the USA, the direct and indirect costs for COPD are

> © 2013 Uzun et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.
