Etiological profile of exacerbations of chronic obstructive pulmonary disease

<bold>Introduction:</bold> An exacerbation of chronic obstructive pulmonary disease (COPD) is an acute event defined by an increase in one or more symptoms of the disease within a period of 14 days or less. It is a source of high morbi-mortality. <bold>Methods:</bold> We propose a retrospective study spread over eleven years from January 2012 to February 2023 involving 308 cases of COPD exacerbations, collated at the respiratory diseases department of CHU Ibn Rochd in Casablanca. <bold>Results:</bold> There were 276 men and 32 women. The average age was 64 years. The mean number of exacerbations per year was three. Their causes were dominated by bacterial suprinfection in 72% of cases, pneumothorax in 28% and pulmonary embolism in 8%. Bacteriological examination of sputum isolated a germ in 32% of cases. Streptococcus pneumoniae was found in 48% of cases, and Haemophilus influenzae in 43%. According to GOLD 2023, COPD was classified as stage V in 5% of cases, stage IV in 11%, stage III in 41%, stage II in 31% and stage I in 12%. The therapeutic strategy was based on low-flow oxygen therapy combined with probabilistic antibiotic therapy in 78% of cases, with oral corticosteroid therapy, Salbutamol nebulizer cycles and anticoagulant treatment. Thoracic drainage was performed in 28% of cases, and bullae resection with pleural symphysis in 4%. Background treatment for COPD was prescribed in all cases, with good outcome in 64% of cases, marked by recurrence of exacerbation in 36% and death in 18 cases. <bold>Conclusion:</bold> In our context, the etiologies of COPD exacerbations are multiple, with bacterial superinfection at the top of the list. We emphasize the importance of prevention, which relies primarily on the fight against smoking.