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Methods: We studied 205 patients with COPD (mean [[+ or -]SD] FEV(1), 43 [+ or -] 15% predicted), and recorded the body mass index, FEV1 percent predicted, modified Medical Research Council dyspnea scale, 6-min walk distance, and the BODE index at baseline, during the exacerbation, and at 6, 12, and 24 months following the first episode, and documented all exacerbations for 2 years after the first acute exacerbation.