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• W3022952209 abstract "To the EditorThe article by Niewoehner and coworkers (January 2007)1Niewoehner DE Lokhnygina Y Rice K et al.Risk indexes for exacerbations and hospitalizations due to COPD.Chest. 2007; : 20-28Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar is a much-needed contribution to the better understanding of COPD. Using prospective data, the authors propose risk indexes that are able to predict COPD exacerbations and related hospitalizations. These indexes include spirometry variables and a few clinical variables (age of the patients, unscheduled visits, cardiovascular comorbidity, and some prescribed medications) but do not include data from physical examination. However, in our experience, determining the presence of the Hoover sign (the paradoxical movement of the lateral rib margin during inspiration) may be useful for detecting those COPD patients with a higher risk of exacerbation including hospitalization.The Hoover sign is a frequent finding in the clinical examination of COPD. In a series2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar of 157 stable COPD patients, the sign was present in 36% of patients with moderate COPD, 43% of patients with severe COPD, and 76% of patients with very severe COPD. In our studies,2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar3Garcia-Pachon E Padilla-Navas I Clinical implications of Hoover's sign in chronic obstructive pulmonary disease.Eur J Intern Med. 2004; 15: 50-53Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar the presence of the Hoover sign was independently associated with a higher dyspnea level and a higher number of exacerbations including hospitalizations. The Hoover sign is easy to detect, and there is good agreement between observers with different clinical experience.4Garcia-Pachon E Paradoxical movement of the lateral rib margin (Hoover sign) for detecting obstructive airway disease.Chest. 2002; 122: 651-655Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar In addition, it may be useful for differentiating the cardiac from the respiratory origin of acute dyspnea.5Garcia-Pachon E Padilla-Navas I Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea.Rev Clin Esp. 2005; 205: 113-115Crossref PubMed Scopus (4) Google Scholar In view of our experience, we propose including this physical sign in the evaluation of possible risk indexes for exacerbations in COPD patients. To the EditorThe article by Niewoehner and coworkers (January 2007)1Niewoehner DE Lokhnygina Y Rice K et al.Risk indexes for exacerbations and hospitalizations due to COPD.Chest. 2007; : 20-28Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar is a much-needed contribution to the better understanding of COPD. Using prospective data, the authors propose risk indexes that are able to predict COPD exacerbations and related hospitalizations. These indexes include spirometry variables and a few clinical variables (age of the patients, unscheduled visits, cardiovascular comorbidity, and some prescribed medications) but do not include data from physical examination. However, in our experience, determining the presence of the Hoover sign (the paradoxical movement of the lateral rib margin during inspiration) may be useful for detecting those COPD patients with a higher risk of exacerbation including hospitalization.The Hoover sign is a frequent finding in the clinical examination of COPD. In a series2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar of 157 stable COPD patients, the sign was present in 36% of patients with moderate COPD, 43% of patients with severe COPD, and 76% of patients with very severe COPD. In our studies,2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar3Garcia-Pachon E Padilla-Navas I Clinical implications of Hoover's sign in chronic obstructive pulmonary disease.Eur J Intern Med. 2004; 15: 50-53Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar the presence of the Hoover sign was independently associated with a higher dyspnea level and a higher number of exacerbations including hospitalizations. The Hoover sign is easy to detect, and there is good agreement between observers with different clinical experience.4Garcia-Pachon E Paradoxical movement of the lateral rib margin (Hoover sign) for detecting obstructive airway disease.Chest. 2002; 122: 651-655Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar In addition, it may be useful for differentiating the cardiac from the respiratory origin of acute dyspnea.5Garcia-Pachon E Padilla-Navas I Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea.Rev Clin Esp. 2005; 205: 113-115Crossref PubMed Scopus (4) Google Scholar In view of our experience, we propose including this physical sign in the evaluation of possible risk indexes for exacerbations in COPD patients. The article by Niewoehner and coworkers (January 2007)1Niewoehner DE Lokhnygina Y Rice K et al.Risk indexes for exacerbations and hospitalizations due to COPD.Chest. 2007; : 20-28Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar is a much-needed contribution to the better understanding of COPD. Using prospective data, the authors propose risk indexes that are able to predict COPD exacerbations and related hospitalizations. These indexes include spirometry variables and a few clinical variables (age of the patients, unscheduled visits, cardiovascular comorbidity, and some prescribed medications) but do not include data from physical examination. However, in our experience, determining the presence of the Hoover sign (the paradoxical movement of the lateral rib margin during inspiration) may be useful for detecting those COPD patients with a higher risk of exacerbation including hospitalization. The Hoover sign is a frequent finding in the clinical examination of COPD. In a series2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar of 157 stable COPD patients, the sign was present in 36% of patients with moderate COPD, 43% of patients with severe COPD, and 76% of patients with very severe COPD. In our studies,2Garcia-Pachon E Padilla-Navas I Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.Int J Clin Pract. 2006; 60: 514-517Crossref PubMed Scopus (17) Google Scholar3Garcia-Pachon E Padilla-Navas I Clinical implications of Hoover's sign in chronic obstructive pulmonary disease.Eur J Intern Med. 2004; 15: 50-53Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar the presence of the Hoover sign was independently associated with a higher dyspnea level and a higher number of exacerbations including hospitalizations. The Hoover sign is easy to detect, and there is good agreement between observers with different clinical experience.4Garcia-Pachon E Paradoxical movement of the lateral rib margin (Hoover sign) for detecting obstructive airway disease.Chest. 2002; 122: 651-655Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar In addition, it may be useful for differentiating the cardiac from the respiratory origin of acute dyspnea.5Garcia-Pachon E Padilla-Navas I Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea.Rev Clin Esp. 2005; 205: 113-115Crossref PubMed Scopus (4) Google Scholar In view of our experience, we propose including this physical sign in the evaluation of possible risk indexes for exacerbations in COPD patients." @default.
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• W3022952209 title "Risk Indexes for COPD Exacerbations I" @default.
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