Characteristics of acute exacerbation in COPD according to the intensity of tobacco intoxication

<bold>Introduction:</bold> Active smoking is the main etiology of chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the impact of the intensity of smoking intoxication on the characteristics of acute exacerbation (AE) in COPD. <bold>Methods:</bold> Retrospective study including 110 patients followed for COPD at the Pneumology Department D of in Ariana between 2011 and 2021. One hundred and two patients were smokers. We divided these patients into 2 groups according to the intensity of smoking intoxication assessed in number of pack-years (PA): G1:82 patients with a PA number ≥ 30PA and G2: 20 patients with a PA number < 30PA. <bold>Results:</bold> The mean consumption was 56PA with a mean age of onset of smoking of 22 years. The mean age of patients was 67 years with no significant difference between the 2 groups (68 Vs 66 years; p=0.2) with a male predominance in G1 (85.1% Vs 14.9%; p=0.001). The mean number of severe AE per year and the mean number of hospitalizations per year were higher in G1, with respectively (1.33 Vs 0.74 AE per year, p= 0.03) and (1.1 Vs 0.85 hospitalizations per year, p=0.03). Bronchial superinfection was more frequent in G1 (87.1% Vs 12.9%, p=0.013). The use of oxygen therapy (68.3% Vs 53.6%; p=0.1) was comparable between the two groups. The use of non-invasive acute ventilation (30.5% Vs 10.7%; p=0.06) was more frequent in G1. Length of stay during AE was similar between the two groups (10 ±6 days Vs 9 ±4 days; p=0.3). <bold>Conclusion:</bold> The intensity of smoking intoxication appears to influence the number of severe AE and hospitalizations in COPD.