The effect of smoking on the severity of mechanisms of acute exacerbations of COPD
The effect of smoking on the severity of mechanisms of acute exacerbations of COPD
COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of
10% in men and 8.5% in women. Exacerbations of COPD account for
approximately 10% of all acute medical admissions. Projected prevalence
figures suggest that by 2020 COPD will be the third leading cause of mortality
worldwide thus imposing a significant burden on healthcare resources in the
future. Acute exacerbations are not only responsible for a decline in the
patient’s quality of life, but have a major socioeconomic impact. Following a
pilot study that showed current smokers recover lung function much more
slowly from their exacerbation than ex smokers, I initiated a properly powered
prospective study to investigate the difference between the two groups.
A total of 58 patients admitted with acute infectious exacerbations of COPD
were recruited to the study to determine the effect of smoking status on their
exacerbation. Throughout the admission lung function was measured. Sputum
was cultured for bacteria, and PCR used to detect viral infection. Blood and
sputum cells were analyzed by flow cytometry. Serum was collected for CRP
levels.
Ex-smokers recovered significantly more quickly than current smokers in all
spirometric parameters (P<0.01), and were discharged sooner (mean 3.08 vs
5.59 days, P<0.001). Sputum culture was positive for more pathogenic bacteria
in current smokers, especially H. influenzae, which was associated with a
significantly higher CRP rise (p<0.05) than any other organism. CD8+ T cells
predominated in the sputum of ex-smokers while CD4+ T cells were the
dominant cell type in current smokers (p<0.01).
Current smoking is a risk factor for more severe exacerbations, delayed
recovery and prolonged hospitalization. This may result from a variety of factors
including bacterial, immune mediated responses and systemic inflammation.
Bourne, Simon Charles
c17aed54-c75b-4e82-957b-81b3279dfa01
October 2008
Bourne, Simon Charles
c17aed54-c75b-4e82-957b-81b3279dfa01
Djukanovic, R.
d9a45ee7-6a80-4d84-a0ed-10962660a98d
Marshall, B.
9abf382c-977f-459c-9b91-5ed8cbf2284f
Bourne, Simon Charles
(2008)
The effect of smoking on the severity of mechanisms of acute exacerbations of COPD.
University of Southampton, School of Medicine, Doctoral Thesis, 125pp.
Record type:
Thesis
(Doctoral)
Abstract
COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of
10% in men and 8.5% in women. Exacerbations of COPD account for
approximately 10% of all acute medical admissions. Projected prevalence
figures suggest that by 2020 COPD will be the third leading cause of mortality
worldwide thus imposing a significant burden on healthcare resources in the
future. Acute exacerbations are not only responsible for a decline in the
patient’s quality of life, but have a major socioeconomic impact. Following a
pilot study that showed current smokers recover lung function much more
slowly from their exacerbation than ex smokers, I initiated a properly powered
prospective study to investigate the difference between the two groups.
A total of 58 patients admitted with acute infectious exacerbations of COPD
were recruited to the study to determine the effect of smoking status on their
exacerbation. Throughout the admission lung function was measured. Sputum
was cultured for bacteria, and PCR used to detect viral infection. Blood and
sputum cells were analyzed by flow cytometry. Serum was collected for CRP
levels.
Ex-smokers recovered significantly more quickly than current smokers in all
spirometric parameters (P<0.01), and were discharged sooner (mean 3.08 vs
5.59 days, P<0.001). Sputum culture was positive for more pathogenic bacteria
in current smokers, especially H. influenzae, which was associated with a
significantly higher CRP rise (p<0.05) than any other organism. CD8+ T cells
predominated in the sputum of ex-smokers while CD4+ T cells were the
dominant cell type in current smokers (p<0.01).
Current smoking is a risk factor for more severe exacerbations, delayed
recovery and prolonged hospitalization. This may result from a variety of factors
including bacterial, immune mediated responses and systemic inflammation.
Text
The_effect_of_smoking_on_the_severity,_and_mechanisms_of_acu.pdf
- Other
More information
Published date: October 2008
Organisations:
University of Southampton
Identifiers
Local EPrints ID: 67617
URI: http://eprints.soton.ac.uk/id/eprint/67617
PURE UUID: bd5112f7-15c4-4358-b74d-0b51c77a3eb1
Catalogue record
Date deposited: 02 Sep 2009
Last modified: 14 Mar 2024 02:33
Export record
Contributors
Author:
Simon Charles Bourne
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
