{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T07:33:31Z","timestamp":1776238411935,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,9]],"date-time":"2020-02-09T00:00:00Z","timestamp":1581206400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001078","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001078","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004504","name":"Lietuvos Mokslo Taryba","doi-asserted-by":"publisher","award":["MIP\u2010049\/2015"],"award-info":[{"award-number":["MIP\u2010049\/2015"]}],"id":[{"id":"10.13039\/501100004504","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011568","name":"Minist\u00e8re de la Transition \u00e9cologique et Solidaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011568","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Exacerbations of chronic obstructive pulmonary disease (COPD) are common in emergency departments (ED). Guidelines recommend administration of inhaled bronchodilators, systemic corticosteroids and antibiotics along with non\u2010invasive ventilation (NIV) for patients with respiratory acidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine compliance with guideline recommendations for patients treated for COPD in ED in Europe (EUR) and South East Asia\/Australasia (SEA) and to compare management and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In each region, an observational prospective cohort study was performed that included patients presenting to ED with the main complaint of dyspnoea during three 72\u2010h periods. This planned sub\u2010study included those with an ED primary discharge diagnosis of COPD. Data were collected on demographics, clinical features, treatment, disposition and in\u2010hospital mortality. We determined overall compliance with guideline recommendations and compared treatments and outcome between regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 801 patients was included from 122 ED (66 EUR and 46 SEA). Inhaled bronchodilators were administered to 80.3% of patients, systemic corticosteroids to 59.5%, antibiotics to 44 and 60.6% of patients with pH &lt;7.3 received NIV. The proportion administered systemic corticosteroids was higher in SEA (EUR vs SEA for all comparisons; 52 vs 66%, <jats:italic>P<\/jats:italic> &lt; 0.001) as was administration of antibiotics (40 vs 49%, <jats:italic>P<\/jats:italic> = 0.02). Rates of NIV and mechanical ventilation were similar. Overall in\u2010hospital mortality was 4.2% (SEA 3.9% vs EUR 4.5%, <jats:italic>P<\/jats:italic> = 0.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compliance with guideline recommended treatments, in particular administration of corticosteroids and NIV, was sub\u2010optimal in both regions. Improved compliance has the potential to improve patient outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14323","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T02:50:27Z","timestamp":1555383027000},"page":"200-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Get with the guidelines: management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub\u2010optimal"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-5023","authenticated-orcid":false,"given":"Anne\u2010Maree","family":"Kelly","sequence":"first","affiliation":[{"name":"Joseph Epstein Centre for Emergency Medicine Research Western Health  Melbourne Victoria Australia"},{"name":"Department of Medicine, Melbourne Medical School \u2013 Western Precinct The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oene","family":"Van Meer","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerben","family":"Keijzers","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Gold Coast Unviersty Hospital  Gold Coast Queensland Australia"},{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"},{"name":"School of Medicine Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justina","family":"Motiejunaite","sequence":"additional","affiliation":[{"name":"INSERM BIOmarkers in CArdioNeuroVAScular diseases  Paris France"},{"name":"Department of Anesthesiology and Critical Care APHP, Saint Louis Lariboisi\u00e8re Hospitals  Paris France"},{"name":"Department of Cardiology Lithuanian University of Health Sciences Kaunas Clinics  Kaunas Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Auckland City Hosptial  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Body","sequence":"additional","affiliation":[{"name":"Emergency Department Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"},{"name":"Cardiovascular Sciences Research Group The University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Craig","sequence":"additional","affiliation":[{"name":"Emergency Department Monash Medical Centre  Melbourne Victoria Australia"},{"name":"School of Clinical Sciences at Monash Health Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Karamercan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Emergency Medicine Department Gazi University  Ankara Turkey"},{"name":"Department of Emergency Medicine Istanbul Bagcilar Training and Research Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Klim","sequence":"additional","affiliation":[{"name":"Joseph Epstein Centre for Emergency Medicine Research Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veli\u2010Pekka","family":"Harjola","sequence":"additional","affiliation":[{"name":"Emergency Medicine University of Helsinki  Helsinki Finland"},{"name":"Department of Emergency Medicine and Services Helsinki University Hospital  Helsinki 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adela","family":"Golea","sequence":"additional","affiliation":[{"name":"Emergency Department of the University County Emergency Hospital University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin A.","family":"Graham","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Capsec","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department Tours University Hospital  Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinzia","family":"Barletta","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St Eugenio Hospital  Rome 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