Volume 7, Issue 2 (11-2021)
Journal of Research in Applied and Basic Medical Sciences 2021, 7(2): 62-67 |
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Department of Microbiology, Nandkumar Singh Chouhan Government Medical College, Khandwa-450001, Madhya Pradesh, India , drrameshagrawal22@gmail.com
Abstract: (1927 Views)
Background & Aims: Chronic obstructive pulmonary disease (COPD) is an important cause of mortality and morbidity globally. COPD, if associated with multiple comorbidities, has a greater impact on treatment outcome and hospital stay, hence effective control of COPD is crucial for enhancing quality of life. Our study assesses the effect of comorbidities on management outcomes in acute exacerbations of COPD patients.
Materials & Methods: An analytical cross-sectional study was planned on 630 patients. Patients with acute exacerbations of COPD who were admitted to pulmonary ward and ICU were enrolled in the study. Data analysis was done using MS Excel and SPSS version 21.0. Unpaired students’t-test was used and p < 0.05 was taken to be statistically significant.
Results: 61.9% of patients had at least one associated comorbidity e.g. CAD (37.2%), hypertension (28.2%), diabetes mellitus (24.3%), and CVD (10.3%). We found that acute exacerbation of COPD patients with comorbidities had prolonged hospital stay, greater ICU admissions, and need for invasive ventilation as compared to those without comorbidities. Presence of comorbidities with COPD was significantly associated with duration of hospital stay.
Conclusion: Comorbidities associated with acute exacerbations of COPD increase the hospital stay, need for ICU admission and more invasive ventilation, and reduce the impact of treatments.
Materials & Methods: An analytical cross-sectional study was planned on 630 patients. Patients with acute exacerbations of COPD who were admitted to pulmonary ward and ICU were enrolled in the study. Data analysis was done using MS Excel and SPSS version 21.0. Unpaired students’t-test was used and p < 0.05 was taken to be statistically significant.
Results: 61.9% of patients had at least one associated comorbidity e.g. CAD (37.2%), hypertension (28.2%), diabetes mellitus (24.3%), and CVD (10.3%). We found that acute exacerbation of COPD patients with comorbidities had prolonged hospital stay, greater ICU admissions, and need for invasive ventilation as compared to those without comorbidities. Presence of comorbidities with COPD was significantly associated with duration of hospital stay.
Conclusion: Comorbidities associated with acute exacerbations of COPD increase the hospital stay, need for ICU admission and more invasive ventilation, and reduce the impact of treatments.
Type of Study: orginal article |
Subject:
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References
1. Lamprecht B, Soriano JB, Studnicka M, Kaiser B, Vanfleteren LE, Gnatiuc L, et al. Determinants of underdiagnosis of COPD in national and international surveys. Chest 2015;148 (4):971-85. [DOI:10.1378/chest.14-2535]
2. Patel AR, Hurst JR. Extrapulmonary comorbidities in chronic obstructive pulmonary disease: state of the art. Expert Rev Respir Med 2011;5(5): 647- 62. [DOI:10.1586/ers.11.62]
3. Smith MC, Wrobel JP. Epidemiology and clinical impact of major comorbidities in patients with COPD. Int J Chron Obstruct Pulmon Dis 2014; 9: 871- 88. [DOI:10.2147/COPD.S49621]
4. Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010; 11: 122. [DOI:10.1186/1465-9921-11-122]
5. Cavaillès A, Brinchault-Rabin G, Dixmier A, Goupil F, Gut-Gobert C, Marchand-Adam S, et al. Comorbidities of COPD. Eur Respir Rev 2013;22(130):454-75. Epping-Jordan JE, Galea G, Tukuitonga C, Beaglehole R. Preventing chronic diseases: taking stepwise action. Lancet 2005; 366: 1667-71. [DOI:10.1016/S0140-6736(05)67342-4]
6. Simon-Tuval T, Scharf SM, Maimon N, Bernhard-Scharf BJ, Reuveni H, Tarasiuk A. Determinants of elevated healthcare utilization in patients with COPD. Respir Res 2011;12:7. [DOI:10.1186/1465-9921-12-7]
7. Lee H, Rhee CK, Lee BJ, Choi DC, Kim JA, Kim SH, et al. Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database. Int J Chron Obstruct Pulmon Dis 2016;11:775-83. [DOI:10.2147/COPD.S95954]
8. Global Initiative for Chronic Obstructive Lung Disease (GOLD). From the global strategy for the diagnosis, management and prevention of COPD. 2017. Available from: http://goldcopd.org. Accessed March 16, 2020.
9. Terzano C, Colamesta V, Unim B, Romani S, Meneghini A, Volpe G, et al. Chronic obstructive pulmonary disease (COPD) exacerbation: impact of comorbidities on length and costs during hospitalization. Eur Rev Med Pharmacol Sci 2017;21:3680-9. [Google Scholar]
10. Crisafulli E, Costi S, Luppi F, Cirelli G, Cilione C, Coletti O, et al. Role of comorbidities in a cohort of patients with COPD undergoing pulmonary rehabilitation. Thorax 2008;63:487-92. [DOI:10.1136/thx.2007.086371]
11. Hillas G, Perlikos F, Tsiligianni I, Tzanakis N. Managing comorbidities in COPD, Int J Chron Obstruct Pulmon Dis 2015;10: 95-109. [DOI:10.2147/COPD.S54473]
12. Schwab P, Dhamane AD, Hopson SD, Moretz C, Annavarapu S, Burslem K, et al. Impact of comorbid conditions in COPD patients on health care resource utilization and costs in predominantly Medicare population. Int J Chron Obstruct Pulmon Dis 2017;12: 735-44. [DOI:10.2147/COPD.S112256]
13. Van Manen JG, Bindels PJ, Lizermans CJ, van der Zee JS, Bottema BJ, Schadé E. Prevalence of comorbidity in patients with chronic airway obstruction and controls over the age of 40. J Clin Epidemiol 2001;54(3):287-93. [DOI:10.1016/S0895-4356(01)00346-8]
14. Fumagalli G, Fabiani F, Forte S, Napolitano M, Marinelli P, Palange P, et al. INDACO project: a pilot study on incidence of comorbidities in COPD patients referred to pneumology units. Multidiscip Respir Med 2013;8(1):28. [DOI:10.1186/2049-6958-8-28]
15. Mapel DW, Hurley JS, Frost FJ, Petersen HV, Picchi MA, Coultas DB. Health care utilization in chronic obstructive pulmonary disease. A case-control study in a health maintenance organization. Arch Intern Med 2000;160(17):2653-8. [DOI:10.1001/archinte.160.17.2653]
16. Frei A, Muggensturm P, Putcha N, Siebeling L, Zoller M, Boyd CM, et al. Five comorbidities reflected the health status in patients with chronic obstructive pulmonary disease: the newly developed COMCOLD index. J Clin Epidemiol 2014;67(8):904-11. [DOI:10.1016/j.jclinepi.2014.03.005]
17. Koskela J, Kilpeläinen M, Kupiainen H, Mazur W, Sintonen H, Boezen M, et al. Co-morbidities are the key nominators of the health related quality of life in mild and moderate COPD. BMC Pulm Med 2014;14(1):102. [DOI:10.1186/1471-2466-14-102]
18. Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G. Prevalence of comorbidities in patients with chronic obstructive pulmonary disease. Respiration 2010;80(2):112-9. [DOI:10.1159/000281880]
19. Sidney S, Sorel M, Quesenberry CP Jr, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease. Hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 2005;128(4):2068-75. [DOI:10.1378/chest.128.4.2068]
20. Lopez Varela MV, Montes de Oca M, Halbert RJ, Muiño A, Perez-Padilla R, Tálamo C, et al; PLATINO Team. Sex-related differences in COPD in five Latin American cities: the PLATINO study. Eur Respir J 2010;36(5):1034-41. [DOI:10.1183/09031936.00165409]
21. Anecchino C, Rossi E, Fanizza C, De Rosa M, Tognoni G, Romero M. Working Group ARNO Project. Prevalence of chronic obstructive pulmonary disease and pattern of comorbidities in a general population. Int J Chron Obstruct Pulmon Dis 2007;2(4):567–74. Miyazaki M, Nakamura H, Chubachi S, Sasaki M, Haraguchi M, Yoshida S, et al; Keio COPD Comorbidity Research (K-CCR) Group. Analysis of comorbid factors that increase the COPD assessment test scores. Respir Res 2014 ;15(1):13. [PubMed]
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