Frequently used definitions and diagnostic criteria for COPD exacerbations
| GOLD definition | ‘Acute exacerbations are episodes of acute worsening of the respiratory symptoms of patients with COPD, that result in additional therapy1 |
| Consensus conference 2002 (Rodriguez-Roisin) definition | ‘In patients with underlying COPD, exacerbation is an acute sustained symptoms worsening from the stable state that is beyond normal day-to-day variation and necessitates a change in regular medications13 |
| COPD-X (Australian and New Zealand Guidelines) | ‘A COPD exacerbation is characterized by a change in the patient’s baseline dyspnea, cough, and/or sputum that is beyond normal day-to-day variations, is acute in onset, and may warrant a change in regular medication or hospital admission20 |
| NICE (UK Guidelines) | ‘An exacerbation is a sustained worsening of the patient’s symptoms from their usual stable state which is beyond day-to-day variations and is acute in onset. Commonly reported symptoms are worsening breathlessness, cough, increased sputum production and change in sputum colour. The change in these symptoms often necessitates a change in medication2 |
| Anthonisen criteria | ‘In patients with underlying COPD, an exacerbation is an acute, sustained deterioration of at least two of the following symptoms: Increased sputum volume; increased sputum purulence; breathlessness’23 |
| Modified Anthonisen criteria | ‘In patients with underlying COPD, an exacerbation is an acute sustained deterioration of at least two of the following major symptoms or at least one major and one minor symptom. Major symptoms: Increased sputum volume; increased sputum purulence; breathlessness. Minor symptoms: cough; wheeze; nasal discharge; sore throat; pyrexia’24 |
| EXACT criteria | ‘The EXACT patient-reported diary is a patient-reported outcome measure developed to identify COPD exacerbations, by quantifying daily the intensity of the following symptoms: congestion, cough, sputum production, sputum thickness, chest discomfort, chest tightness, and breathlessness. An exacerbation is defined by an increase of at least 12 points for two consecutive days or an increase of at least 9 points for at least three consecutive days’25 |
COPD, chronic obstructive pulmonary disease; EXACT, The Exacerbations of Chronic Pulmonary Disease Tool; GOLD, Global Initiative for Chronic Obstructive Lung Disease; NICE, National Institute for Health and Care Excellence; NICE, The National Institute for Health and Care Excellence.