Characteristics of length of stay and cardiovascular pharmacotherapy advice among chronic obstructive pulmonary disease patients

Chronic obstructive pulmonary disease (COPD) increases the global disease burden due to its diverse adverse health effects on the respiratory and cardiovascular systems. This study aimed to elucidate the potential indicators of length of stay (LOS) and pharmacotherapy advice among COPD patients. Thereafter, hospitalized COPD patients with clinical records and respiratory and cardiovascular pharmacotherapy advice were retrospectively collected from a tertiary hospital between April 2017 and September 2020, and the determinants of LOS and cardiovascular pharmacotherapy advice were explored using regression analyses. Overall, 475 patients with COPD were recruited and stratified according to exacerbation and presence of Cor pulmonale (CP). The extended LOS, increased B-type natriuretic peptides (BNP), and a higher percentage of cardiovascular pharmacotherapy advice were observed in COPD with CP regardless of exacerbation, although the percentage of respiratory prescriptions was comparable. The presence of CP indicated a longer LOS ( B = 1.850, p < 0.001) for COPD regardless of exacerbation. Meanwhile, elevated BNP levels indicated cardiovascular pharmacotherapy advise for both COPD in exacerbation (OR = 1.003, p = 0.012) and absence of exacerbation (OR = 1.006, p = 0.015). Moreover, advice for trimetazidine use for COPD in exacerbation (OR = 1.005, p = 0.002) has been suggested. Therefore, CP appears to be an important comorbidity resulting in extended LOS for COPD, which is likely to be advised with cardiovascular pharmacotherapy, which might be guided through BNP monitoring.

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Accuracy of the Hospital Anxiety and Depression Scale for Identifying Depression in Chronic Obstructive Pulmonary Disease Patients

Pulmonary Medicine ◽

10.1155/2014/973858 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Christoph Nowak ◽

Noriane A. Sievi ◽

Christian F. Clarenbach ◽

Esther Irene Schwarz ◽

Christian Schlatzer ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Diagnostic Accuracy ◽

Pulmonary Disease ◽

Depression Scale ◽

Anxiety And Depression ◽

Chronic Obstructive ◽

Hospital Anxiety ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Clinical Records

Psychological morbidity is common in chronic respiratory diseases. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) and risk factors for comorbid depression in chronic obstructive pulmonary disease (COPD) are addressed. Consecutive COPD patients (GOLD stage I–IV, 40–75 years old) were enrolled in a multicentre, cross-sectional cohort study. Diagnosis of depression was ascertained through clinical records. Lung function, HADS score, 6-minute walking test (6-MWT), MRC dyspnoea score, and COPD Assessment Test (CAT) were evaluated. Two hundred fifty-nine COPD patients (mean age 62.5 years; 32% female; mean FEV1 48% predicted) were included. Patients diagnosed with depression (29/259; 11.2%) had significantly higher HADS-D and HADS-Total scores than nondepressed patients (median (quartiles) HADS-D 6 [4; 9] versus 4 [2; 7], median HADS-Total 14 [10; 20] versus 8 [5; 14]). Receiver-operating characteristic plots showed moderate accuracy for HADS-D, AUC 0.662 (95%CI 0.601–0.719), and HADS-Total, AUC 0.681 (95%CI 0.620–0.737), with optimal cut-off scores of >5 and >9, respectively. Sensitivity and specificity were 62.1% and 62.6% for HADS-D compared to 75.9% and 55.2% for HADS-Total. Age, comorbidities, sex, and lower airflow limitation predicted depression. The HADS exhibits low diagnostic accuracy for depression in COPD patients. Younger men with comorbidities are at increased risk for depression.

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Prevalence of Chronic Cor Pulmonale in Chronic Obstructive Pulmonary Disease Patients in a Teaching Hospital in Nepal

Journal of Institute of Medicine ◽

10.3126/jiom.v41i1.28586 ◽

2019 ◽

Vol 41 (1) ◽

pp. 15-19

Author(s):

Matina Sayami ◽

Suman Baral ◽

Rakshya Shrestha ◽

Dambar B Karki

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Teaching Hospital ◽

College Teaching ◽

Cor Pulmonale ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Chronic Cor Pulmonale ◽

Severe Copd

Introduction: Chronic obstructive pulmonary disease (COPD) is the most common cause of cor pulmonale. Cor pulmonale in COPD is associated with decreased survival, increased hospitalization and mortality. In this study we aim to find out the prevalence of chronic cor pulmonale in COPD patients which would help in prevention of right sided heart failure and improve patients’ quality of life. Methods: This was a cross sectional observational study done in Kathmandu Medical College Teaching Hospital, Nepal. 50 COPD patients above the age of 30 years attending the outpatient department or admitted in wards were included. All COPD patients diagnosed by pulmonary function test (PFT) were assessed for cor pulmonale by echocardiography (ECHO). The demographic data, chest X-ray, PFT, electrocardiography (ECG) and ECHO findings were recorded, entered and analyzed using SPSS software, version 17. Results: Most of the patients enrolled in the study were between age group of 51-60 with female preponderance. 68% of the COPD patients had chronic cor pulmonale. Out of 21 male, 76.2% and out of 29 female COPD patients, 62.06% had cor pulmonale. Cor pulmonale was present in 53.12% and 94.4% of patients who had COPD for < 10 years and ≥10 years duration respectively. Cor pulmonale was present in 76% patients with severe COPD, 75% of patients with moderate COPD, 64.2% patients with very severe COPD and none of the patients with mild COPD. Pulmonary hypertension (PH) was present in 67.64% of cor pulmonale patients. Conclusion: The prevalence of chronic cor pulmonale in COPD patients was 68%. It was more in male patients, highest in patients with severe COPD, and the prevalence increased with duration of COPD. PH was present in 67.64% of cor pulmonale patients.

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The Prevalence of Liver Diseases among Chronic Obstructive Pulmonary Disease Patients: Statistics from Riyadh, Saudi Arabia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i55a33815 ◽

2021 ◽

pp. 127-135

Author(s):

Majed Alghamdi ◽

Bussma Ahmed Bugis ◽

Alaa Bugis ◽

Nader Alharbi ◽

Saleh Mohammed Alotaibi ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Saudi Arabia ◽

Liver Disease ◽

Pulmonary Disease ◽

Liver Diseases ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Alpha 1 Antitrypsin ◽

Clinical Records

Background: Alpha-1 antitrypsin is an important protein produced by the liver, and deficiency in this protein will cause many liver diseases. A deficiency in this protein can cause congenital emphysema, characterized by damaged and stretched air sacs of the lungs. To our knowledge, limited studies have been performed on liver disease prevalence among chronic obstructive pulmonary disease (COPD) patients in Saudi Arabia. Methods: This study was a secondary data analysis of existing clinical records and aimed at determining the prevalence and association of liver diseases among COPD patients from 2016 to 2020. A total of 1579 clinical records were collected. In this study we analyzed one hundred fifty-five records. Results: Senior patients who were aged 65 or older represented most patients (61.29%). In addition, 81% of the selected COPD patients were diagnosed with cirrhosis, while only one patient was diagnosed with fibrosis. Senior COPD patients aged 65 years or older were more likely to be diagnosed clinically with any type of liver disease (61.75%) than those from younger age groups. Conclusions: Screening and expression tests for patients showing liver and lung diseases are the procedures to determine whether symptoms are due to alpha-1 antitrypsin deficiency. However, this is challenging in patients with COPD.

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EFFECTIVENESS OF BRONCHODILATOR AND CORTICOSTEROID TREATMENT IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Journal of Pharmaceutical Science and Application ◽

10.24843/jpsa.2020.v02.i01.p03 ◽

2020 ◽

Vol 2 (1) ◽

pp. 17

Author(s):

Putu Rika Veryanti ◽

Ainun Wulandari

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Length Of Stay ◽

Pulmonary Disease ◽

Clinical Condition ◽

Average Length ◽

Chronic Obstructive ◽

Blood Gas ◽

Obstructive Pulmonary Disease ◽

Average Length Of Stay ◽

Copd Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic airway disease which is characterized by progressive airway obstruction. Bronchodilators and corticosteroids are the first choices of therapy in COPD patients. The goal therapy of COPD patients is to prevent respiratory failure, which can impact on death. But nowadays, the mortality rate due to COPD continues to increase. WHO predicts mortality from COPD in the year 2030 will be ranked third in the world. This high mortality can be caused by the ineffectiveness of therapy given. Objective: The aim of this study is to find out the effectiveness of bronchodilator and corticosteroid treatments in COPD patients. Methods: An observational study conducted retrospectively in the 2018 period at Fatmawati Central General Hospital. The effectiveness of therapy was assessed from the patient's clinical condition, blood gas values (PaO2 & PaCO2) and the average length of stay (AvLOS). Results: COPD was mostly suffered by males (83,33%), and the highest age for COPD was in the range of 45 years and above (90%). Bronchodilator that commonly prescribed were albuterol (30.08%), ipratropium bromide (12.2%), fenoterol hydrobromide (10.57%), terbutaline sulfate (8.13%), theophylline (1.63%) and aminophylline (5.69%), while the corticosteroids were budesonide (17.07%), methylprednisolone (9.76%) and dexamethasone (4.88%). Bronchodilator and corticosteroid had improved patient's clinical condition (96.67% patients) and also improved PaO2 & PaCO2 values patients. There was a significant improvement in PaO2 and PaCO2 value in COPD patients (p <0.05). Conclusion: Bronchodilator and corticosteroid in COPD patients had improved patient's clinical condition and PaO2 & PaCO2 values, but the average length of stay exceeds the standard (6-9 days). Keywords: Bronchodilator, Corticosteroid, COPD, Blood Gas Analysis, Average Length of Stay

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Features of chronic obstructive pulmonary disease in patients with concomitant diabetes mellitus

Russian Pulmonology ◽

10.18093/0869-0189-2008-0-5-60-65 ◽

2008 ◽

pp. 60-65

Author(s):

E. A. Titova ◽

A. I. Algazin ◽

T. A. Kornilova ◽

I. P. Sokol ◽

E. M. Reutskaya ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Cor Pulmonale ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Co Morbidity ◽

Chronic Cor Pulmonale

Fifty-two patients with chronic obstructive pulmonary disease (COPD) aged 44 to 71 yrs were examined. Of them, 26 ones suffered from type 2 diabetes mellitus (DM). We established that in patients with concomitant DM, COPD has more severe course with more advanced respiratory failure and chronic cor pulmonale and more frequent exacerbations. COPD patients with concomitant DM more often have co-morbidity, such as obesity, ischemic heart disease, chronic heart failure. Co-morbidity of COLD and DM requires more extensive pharmacotherapy.

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Sleep Induced Hypoxemia in Chronic Obstructive Pulmonary Disease

Journal of Nepal Medical Association ◽

10.31729/jnma.2285 ◽

2013 ◽

Vol 52 (191) ◽

Author(s):

Jing Zhang ◽

Yan Wang ◽

Jing Feng ◽

Xin Sun

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Sleep Time ◽

Cor Pulmonale ◽

Chronic Obstructive ◽

Rapid Eye Movement Sleep ◽

Obstructive Pulmonary Disease ◽

Oxyhemoglobin Saturation ◽

Copd Patients ◽

Alveolar Hypoventilation

Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality worldwide.Sleep-induced hypoxemia is defined as “an SpO2 (oxyhemoglobin saturation) during sleep of <90% for more than five minutes with a nadir of at least 85%” or “> 30% of total sleep time with anSpO2 of < 90%” in subject with a baseline awake SpO2 of ≥ 90%. Patients with moderate or severeCOPD run a high risk of developing SIH mainly because of alveolar hypoventilation and ventilationperfusionmismatch. Compared to their non-SIH brethren, SIH COPD patients have greater degreesof pulmonary hypertension and cor pulmonale, require more frequent hospitalizations, and sustainhigher mortality rates. And the necessity of treatment of isolated SIH in COPD has been debatedfor years. In this mini review, the definition, reasons, prevalence, clinical significance and treatmentapproaches of SIH in COPD are summarized._______________________________________________________________________________________Keywords: chronic obstructive pulmonary disease; polysomnography; rapid eye movement;sleep-induced hypoxemia.

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Predicting Factors Contributing to Length of Stay in Hospitalized Chronic Obstructive Pulmonary Disease (COPD) Patients: The Role of the Emergency Room

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.62 ◽

2004 ◽

Vol 47 (1) ◽

pp. 29-32 ◽

Cited By ~ 3

Author(s):

José Antonio Díaz-Peromingo ◽

Jesús Grandes-Ibáńez ◽

José Manuel Fandińo-Orgeira ◽

Pablo Barcala-Villamarín ◽

Juan Antonio Garrido-Sanjuán

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Length Of Stay ◽

Emergency Room ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Biological Variables ◽

Copd Patients ◽

Breath Sounds ◽

Exacerbation Of Copd

Background: Exacerbation of chronic obstructive pulmonary disease (COPD) is a common cause of hospital admission and COPD patients usually have a long stay in hospital. Methods: The objective of this study was to identify factors predicting length of stay in patients with exacerbation of COPD when seen in the emergency room. We analyzed clinical and biological variables. Results: Patients with diminished breath sounds, systolic pressure higher than 140 mmHg, diastolic pressure higher than 90 mmHg and recent previous hospitalization for exacerbation of COPD had the longest hospital stay. Conclusions: Recognition of this clinical profile in the emergency room may help to increase efforts in order to diminish length of stay in these patients.

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Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00095 ◽

2020 ◽

Vol 29 (2) ◽

pp. 864-872

Author(s):

Fernanda Borowsky da Rosa ◽

Adriane Schmidt Pasqualoto ◽

Catriona M. Steele ◽

Renata Mancopes

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Oral Cavity ◽

Pulmonary Disease ◽

Thermal Sensation ◽

Sensory Function ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Age Related ◽

Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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