Medical Health Encyclopedia

Acute exacerbations include the following symptoms:

• Worsened shortness of breath. This is the most common and distressing acute symptom.
• Increased volume of sputum, which is also typically thicker and greenish in color.
• Wheezing.

Acute exacerbations occur, on average, between two and three times a year in patients with moderate to severe COLD. In about 80% of cases they are triggered by infections. Smokers have more episodes than nonsmokers. Acute exacerbations are self-limited but they are still the most common cause of hospitalization in these patients. Patients with frequent acute exacerbations of COLD are at higher risk for disease deterioration, including reduced quality of life and increasing rates of hospitalizations. Furthermore, in patients who are hospitalized, the morality rates are 11%. Survivors of a first hospitalization have a 50% change of rehospitalization within six months.

Effect on Quality of Life and Mood

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Nearly half of patients with COLD report that daily activities are limited. They have trouble walking up stairs or carrying even small packages. Breathing becomes hard work. More than half of patients with COLD often suffer from insomnia. Such impairment in quality of life can greatly impair mood. If patients with COLD become anxious or depressed, they may have a poorer outlook than those without these emotional problems. Even low-level depression can impair health. Of some concern was a 2003 study reporting a higher rate of suicidal thoughts in patients with COLD or asthma than in those with any other major chronic illness, including arthritis, diabetes, heart disease, and cancer. It is not clear if these results are generally applicable. More research is needed. Certainly, however, psychological interventions may be particularly helpful for these patients.

Medical Complications from Oxygen Deprivation