Diagnosis, Treatment and Comorbidities of Chronic Obstructive Pulmonary Disease patients in Qena Chest Hospital

Abstract

Chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease in the world and is a major cause of morbidity and mortality worldwide. Exposure to tobacco smoke or other air pollutants in susceptible individuals lead s to inflammation in the small airways and progressive destruction of lung parenchyma, resulting in a decline in lung function out of proportion to the normal decline seen with aging(Csikesz and Gartman, 2014). One hundred and eighty two patients fulfilled the diagnostic criteria of COPD, while 84 recruited patients were excluded although that they were previously diagnosed as COPD in which 33 patients proven by spirometery to have no airway obstruction and 51 were asthmatic. The mean age of the patients in the study was 65.0±7.5 and most patients were males 87.9% and only 12.1% were females, and 61.5% of COPD patients lived in rural areas. Most of COPD patients were exposed to organic and inorganic dust in their occupation, most of COPD patients were of low educational level. Most of COPD patients were either current smokers or ex-smokers, cigarette smoking was the most common type of smoking. In females, majority of them used biomass fuels. Most of patients had normal BMI, and there was no significant correlation between the degree of obstruction and BMI. Chephalosporins were the most antibiotics used in the treatment of COPD patients. Theophylline was the most common bronchodilator used, and short course of systemic steroids were commonly used during exacerbation treatment. Short acting B2 agonist inhalers in combination with beclomethasoneor alone were the most commonly usedinhalers, while long acting B2 agonist and anticholinergic (short and long acting) were seldom used. Most of COPD patients were irregular on their treatment, and there was non-significant correlation between FEV1% and compliance of COPD patients. There was no role for vaccination or pulmonary rehabilitation in the management of COPD patients in this study. The mean number of hospitalization was 1.8±2.4 times, the mean rate of exacerbation was 4.1±1.5 times/year. Hypertension, diabetes mellitus, and ischaemic heart disease were the most common comorbidities associated with COPD patients in the current study. Minority of patients had complications in the form of respiratory failure and corpulmonale . In this study, there were 1.1% in mild stage, 2.7% was in moderate stage, 24.7% were in severe stage and 71.4% were in very severe stage.