RATIONALE: Exacerbations are important and heterogeneous events in the natural history of @entity1030 ( @entity1030 ). OBJECTIVES: To examine the consequences of prolonged exacerbation recovery in @entity1 with @entity1030 . METHODS: A cohort of 384 @entity1 with @entity1030 (FEV1 % predicted 45.8 [SD, 16.6] and a median exacerbation rate of 2.13 per year [interquartile range, 1.0-3.2]) were followed for 1,039 days (interquartile range, 660-1,814) between October 1995 and January 2013. @entity1 recorded daily worsening of respiratory symptoms and peak expiratory flow (PEF), and when stable underwent spirometry every 3 months, and completed the St. George's Respiratory Questionnaire annually. Exacerbations were diagnosed as 2 consecutive days with one major symptom plus another respiratory symptom. Exacerbation duration was defined as the time from onset to the day preceding 2 consecutive symptom-free days and recovery in PEF as return to preexacerbation levels. MEASUREMENTS AND MAIN RESULTS: A total of 351 @entity1 had one or more exacerbations. @entity1 with a longer symptom duration (mean, 14.5 d) had a worse St. George's Respiratory Questionnaire total score (0.2 units per 1 day; P   =   0.040). A longer symptomatic duration was associated with a shorter interval between exacerbation recovery and onset of the next exacerbation (hazard ratio, 1.004; P   =   0.013). For 257 (7.3%) exacerbations, PEF did not recover within 99 days. These exacerbations were associated with symptoms of a @entity1800 (cold and sore throat). @entity1 with these nonrecovered exacerbations showed a 10.8 ml/yr (P   <   0.001) faster decline in FEV1. CONCLUSIONS: Prolonged exacerbation symptomatic duration is associated with poorer health status and a greater risk of a new event. Exacerbations where lung function does not recover are associated with symptoms of @entity1800 and accelerated decline in FEV1.

Impact of Prolonged Exacerbation Recovery in XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1800 :: ('MESH:D014777', 'Disease') :: ['viral infections', 'viral infection'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease', 'COPD']
@entity1030 :: (MESH:D029424,Disease) :: ['Chronic Obstructive Pulmonary Disease']
