Chronic Systemic Inflammatory Syndrome in patients with AECOPD presenting to Emergency Department

Abstract. – Background: Chronic ob-structive pulmonary disease (COPD) is thefourth cause of dead in the world. Because ofhigh incidence of comorbidities in COPD pa-tients, it has been proposed a new hypothesisthat inscribe this disease in a complex contestnamed Chronic Systemic Inflammatory Syn-drome (CSIS). Either COPD and the most com-mon comorbidities responsible for its clinicaland natural history, like hypertension, diabetes,coronary artery disease, heart failure, recognizea pro-inflammatory state, marked, for example,by elevated C reactive protein (CRP). Methods: 113 consecutive patients present-ing to Emergency Department (ED) with acuteexacerbated COPD were enrolled. They under-went to full medical history and physical exami-nation. CRP was measured at ED arrival, dis-charge and at 1-6-12 month follow up. CSIS wasdiagnosed according to specified criteria. Results: CSIS was diagnosed in 84% patients.CRP was maximally increased at admission dur-ing the exacerbation, but didn’t correlate withthe severity of it. At discharge, CRP values werelowest; during follow up, CRP demonstrated achaotic behavior growing up till 6 month withoutany correlation with new exacerbation events. At1 year it decreased, never reaching normal val-ues in the majority of our patients thus confirm-ing the presence of a persistent inflammation inCOPD.