Table 3 Exacerbation definitions^a

Treatment

   Burge et al., 2003 [58]^b

Chest problem requiring treatment with oral corticosteroids and/or antibiotics as defined by the treating physician

   Calverley et al., 2003 [59]

Worsening of COPD symptoms that required treatment with antibiotics, oral corticosteroids or both

   Jones et al., 2003 [60]^b

Chest problems requiring treatment with antibiotics and/or oral corticosteroids

   Andersson et al., 2002 [61]

Increased dose of current treatment and/or treatment with antibiotics or systemic corticosteroids and/or general practitioner or outpatient visit or hospital admission

   Burge et al., 2000 [62]^b

Worsening of respiratory symptoms that required treatment with oral corticosteroids, antibiotics or both as judged by the general practitioner

Symptoms

   Effing et al., 2009 [63]

Presence for at least 2 consecutive days of an increase in any two major symptoms or an increase in one major and one minor symptom

   Worth et al., 2009 [64]

A complex of at least two respiratory adverse events with a duration of more than 3 days

   Schermer et al., 2009 [65]

Episode with one or more subsequent unscheduled contacts with either a general practitioner or a chest physician because of worsening of respiratory symptoms

   O'Reilly et al., 2006 [66]^c

Symptom-based: Symptom score of at least 2 for 2 consecutive days with no score for at least two of these symptoms in the previous 5 days Healthcare-based: Need to take antibiotics and/or oral corticosteroids for chest problem

   Wilkinson et al., 2006 [67]

Not defined but specified as symptom-based

   Donaldson et al., 2003 [68]

An increase in either two or more major symptoms or any one major symptom plus any minor symptoms occurring on 2 or more consecutive days

   Seemungal et al., 2000 [69]

Presence for at least 2 consecutive days of an increase in any two major symptoms or an increase in one major and one minor symptom

Treatment and symptoms

   Seemungal et al., 2008 [70]

Sustained worsening of baseline respiratory symptoms for at least 2 days that required treatment with oral corticosteroids and/or antibiotics

   Tashkin et al., 2008 [71]

Increase or new onset of more than one respiratory symptom (cough, sputum, sputum purulence, wheezing or dyspnea) lasting 3 days or more and requiring treatment with an antibiotic or a systemic corticosteroid

   Calverley et al., 2008 [72]

Clinically significant worsening of COPD symptoms requiring treatment with antibiotics and/or systemic steroids

   Wedzicha et al., 2008 [73]

Symptom worsening that required treatment with oral corticosteroids and/or antibiotics or required hospitalization

   Dusser et al., 2006 [74]

Onset of at least one clinical descriptor (worsening of dyspnea, cough or sputum production, appearance of purulent sputum, fever (>38°C), appearance of a new chest radiograph abnormality) lasting ≥2 days and requiring a new prescription or an increase in the dose of β₂-agonists, antibiotics, corticosteroids or bronchodilators

   Soler-Cataluña et al., 2005 [55]

Sustained increase in respiratory symptomatology compared with baseline requiring modification of regular medication and hospital treatment (acute exacerbation of COPD)

   Oostenbrink et al., 2004 [75]

Complex of respiratory symptoms (new onset or worsening of more than one symptom such as cough, sputum, dyspnea or wheeze) lasting for ≥3 days

   Brusasco et al., 2003 [76]

Complex of respiratory symptoms (new onset or an increase in at least one of the following: cough, sputum, dyspnea, wheeze, chest discomfort) lasting at least 3 days and usually associated with therapeutic intervention

Model

   Borg et al., 2004 [77]

Increase in any two major symptoms (dyspnea, sputum purulence, sputum amount) or an increase in one major and one minor symptom (wheeze, sore throat, cough, and symptoms of a common cold, which were nasal congestion and/or discharge) for at least 2 consecutive days

Not defined

   Detournay et al., 2004 [53]

ND