Polycythemia Is a Risk Factor for Mortality in COPD Patients With Pulmonary Embolism

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression. Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital. Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics. Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy. Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients.

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Prevalence Of Pulmonary Embolism In COPD Patients Hospitalized For An Unexplained Wheezing COPD Exacerbation

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5862 ◽

2012 ◽

Author(s):

Claire Andrejak ◽

Claire Poulet ◽

Estelle Hoguet ◽

Eline Magois ◽

Marine Gosset ◽

...

Keyword(s):

Pulmonary Embolism ◽

Copd Exacerbation ◽

Copd Patients

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Abstract P673: The Obesity Paradox in Patients Hospitalized for Ischemic Stroke

Stroke ◽

10.1161/str.52.suppl_1.p673 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Genaro Velazquez ◽

Hafeez Shaka ◽

Hernan G. Marcos-Abdala ◽

Emmanuel Akuna

Keyword(s):

Pulmonary Embolism ◽

Risk Factor ◽

Ischemic Stroke ◽

Respiratory Failure ◽

Hospital Mortality ◽

Odds Ratio ◽

Mechanical Thrombectomy ◽

Length Of Hospital Stay ◽

Obesity Paradox ◽

Secondary Outcomes

Introduction: Even though Obesity, as measured by BMI > 30.00 kg/m 2 , is a established risk factor for ASCVD, it hasn’t been proven as a risk factor for adverse outcomes in patients with diagnosis of ischemic stroke. Our study sought to compare outcomes for ischemic stroke hospitalizations in patients with and without Obesity. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. About 71,473,874who had ischemic stroke as primary diagnosis were enrolled and further stratified based on the presence or absence of Obesity as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, treatment with mechanical thrombectomy, treatment with tPA, and complications like respiratory failure requiring intubation, pulmonary embolism (PE), DVT, NSTEMI and sepsis. Multivariate regression analysis was done to adjust for confounders. Results: The in-hospital mortality for patients with ischemic stroke was 42 145 overall. Compared with patients without obesity, patients with Obesity had a lower odds of in- hospital mortality (aOR 0.85, 95% CI 0.79-0.93, p<0.001) when adjusted for patient and hospital characteristics. We found that patients with ischemic stroke and obesity had decreased length of hospital stay and higher odds ratio of treatment with mechanical thrombectomy, treatment with tPA, and higher odds ratio of complications like respiratory failure requiring intubation and pulmonary embolism (PE). No significant difference in other secondary outcomes (DVT, NSTEMI and sepsis). Conclusion: There is convincing evidence supporting the existence of the “obesity paradox” in patients with ischemic stroke. Several stroke-associated mechanisms, like autonomous nervous activation and pro-inflammatory cytokine release in addition to other factors like impaired feeding and inactivity cause accelerated tissue degradation and overall weight loss. It is thought that obese patients with better metabolic reserve may be less affected from this unfavorable metabolic dysregulation as compared to underweight patients. Nevertheless, further studies are needed in order to identify factors responsible for this paradox.

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