Prevalence of comorbidities in patients admitted with acute exacerbation of COPD in a tertiary care hospital

Syed Ali Abbas, Samina Saboor, Syeda Nabeera Abbas

Abstract


Background:The coexistence of various comorbidities with COPD can be partly explained by their shared risk factor, i.e. cigarette smoking. By 2020, COPD will be the third leading cause of death worldwide. The prevalence of different  comorbidities seen with COPD varies tremendously between studies. The  presence of both COPD and other comorbidities is often ominous and contributes significantly to poor health outcomes. Better understanding of the pathophysiology of COPD and focus on the concept of systemic inflammation has helped in explaining the high frequency of major comorbidities such as cardiovascular,cerebrovascular,skeletal and nutritional disorders . 

Objective: To study the prevalence of various comorbidities in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)inatertiary care hospital in Karachi, Pakistan.

Methodology: This is a retrospective study carried out at the department of Pulmonology, Liaquat National Hospital, Karachi, Pakistan between January 2014 and December2017.This study included patients aged 45 years and above who got admitted in hospita lwith acute exacerbation of COPD.Through the help of EMR (Electronic Medical Records) patients with principal diagnosis of acute exacerbation of COPD on discharge summary were identified. Case records of the selected patients were reviewed and data collected.

Results: For the purpose of this study, during the study period 357 patients with AECOPD(acuteexacerbation of COPD)were identified.There were 280 men and 77 women. The mean age was 57.5 years. 67% were still smoking at just prior to their admission with an acute exacerbation. 34% had significant coal and/or biomass fuel exposure. Hypertension was identified in majority of cases (31%), followed by coronary artery disease (23%) and diabetes (19%). Other comorbidities included (GORD) gastroesophageal reflux disease 13%, dyslipidemia (11%), anxiety/depression (11%), chronic kidney disease (8%) and pulmonaryTB(7%).

Conclusion: There are various comorbidities associated with COPD. Effort should be made to identify each of the comorbidites and its effect on health status. Truly multidisciplinary strategy must be executed to treat not only the airways disease but also any associated disease to improve quality of life and reducemorbidityandmortality.


Keywords


:COPD;Comorbidities;Hypertension;Coronary artery disease

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