scholarly journals Effect of Glycemic Control on Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A411-A411
Author(s):  
Abhraneel Parames Guha
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patients With Diabetes

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is defined as a common preventable and treatable disease that is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. In this article we compared hospital stay between diabetic, non diabetic and prediabetic patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who were treated with corticosteroids. We checked in hospital mortality and 30 day mortality in patients with AECOPD patients with diabetes, Its the first article on this topic from eastern India. Materials and Methods: The study was done in tertiary care centre from November 2017 to April 2019. We included 161 patients with age more than 40 years or more. Patients admitted in hospital with COPD with cough, sputum, dyspnea were included. They were divided into diabetic,prediabetic and non diabetic. We included readmission of patients who were diagnosed previously as AECOPD. Statistical Analysis was performed with help of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). It was a prospective observational study. Results: We found significant association between length of hospital stay and those with AECOPD with diabetes.29.6% of patients with diabetes had a stay of more than two weeks. Hospital stay was found to be 10.8+/-2.30 days in those who had mean random blood sugar (RBS) between 140 -170 mg/dl, 12.98 +/- 2.24 days in those who had RBS between 170–200 mg/dl and 12.62 +/- 3.10 days in those who had RBS more than 200 mg/dl. 89.4% of patient had a BMI (Body mass index) of < 25 kg/square meter. 8.1 % died in hospital and 9.5% died within 30 days of discharge. Among those who were treated with steroids, diabetic patients had a stay of 14.55+/- 0.74 days, compared to prediabetic who had a stay of 14.07+/-1.26 days and non diabetics who had 12.5+/-1.33 days. No association was found between hospital mortality and status of diabetes mellitus. No association was found between 30 day mortality and diabetes mellitus in our study. Conclusion: Diabetes Mellitus and AECOPD are major public health challenges. Whether there is an association between them needs to be addressed, specially in this part of the world. Those patients who were diabetic and treated with steroids had a longer stay than non diabetics and prediabetics. We found no association between hospital mortality and 30 day mortality with diabetes mellitus.

scholarly journals Diabetes mellitus type 2 in hospitalized patients with chronic obstructive pulmonary disease

2015 ◽  
Author(s):  
Evgeni Mekov ◽  
Yanina Slavova ◽  
Marianka Genova ◽  
Adelina Tsakova ◽  
Dimitar Kostadinov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bulgarian Population

Diabetes mellitus (DM) affects 2-37% of patients with chronic obstructive pulmonary disease (COPD), with results being highly variable between studies. DM may also correlate with disease characteristics.The aim of this study was to examine the prevalence of DM and its correlation with comorbidities and COPD characteristics in patients with COPD admitted for exacerbation. 152 patients were studied for presence of DM. All of them were also assessed for vitamin D status and metabolic syndrome (MS). Data were gathered for smoking status and exacerbations during the last year. All patients completed CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires and underwent spirometry. Duration of current hospital stay was recorded. 13.2% (20/152) of patients are taking medications for DM. Additional 21.7% (33/152) have newly discovered DM and 30.9% (47/152) have prediabetes. Only 34.2% of the studied patients do not have DM or prediabetes. 37% (40/108) of males have DM vs. 29,5% (13/44) of females (p=0.379). The prevalence of DM in this study is significantly higher when compared to an unselected Bulgarian population (12,8% in subjects over 45 years). 91% of patients with newly discovered diabetes had glycated hemoglobin (HbA1c)≥6,5% suggesting prolonged hyperglycemia. There is a correlation between the presence of DM and MS (p=0.008). The presence of DM is associated with more severe exacerbations (hospitalizations) during the previous year (p=0.003) and a longer hospital stay (p=0.006). DM is not associated with reduced quality of life and worse pulmonary function. The patients with COPD admitted for exacerbation are at great risk for impaired glucose metabolism which is associated with worse COPD characteristics. The majority of the patients in this study are unaware of having DM.

scholarly journals Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Vol 14 ◽  
pp. 175346662096168
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong-Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.

Blood Eosinophils and Clinical Outcome of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Respiration ◽  
2020 ◽  
pp. 1-10
Author(s):  
Yajie You ◽  
Guo chao Shi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Outcome ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Lower Risk ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

<b><i>Background:</i></b> Numerous studies have shown the association between eosinophilia and clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). But the evidences are lack of consensus. <b><i>Objective:</i></b> The aim of this meta-analysis was to conduct a pooled analysis of outcome comparing eosinophilic (EOS) AECOPD and non-EOS AECOPD patients. <b><i>Methods:</i></b> We included PubMed, EMBASE, Web of Science, and Cochrane databases up to 2020 to retrieve articles. Randomized controlled trials and quasi-experimental studies about patients with and without EOS AECOPD in terms of in-hospital mortality, length of hospital stay, comorbidities, forced expiratory volume in 1 s (FEV1), gender, and BMI were included preclinical studies, review articles, editorials, commentaries, conference abstracts, and book chapters were excluded. The methodologic assessment of studies was performed with the Newcastle-Ottawa Scale and Cochran scale. Comprehensive Rev Man 5 was used for the statistical analysis. <b><i>Results:</i></b> Twenty-one studies with 18,041 patients fulfilled the inclusion criteria and were used in this meta-analysis. Comparing to the non-EOS group, those with EOS AECOPD patients had a lower risk for in-hospital mortality (odds ratio (OR) = 0.59, 95% confidence interval [CI] 0.36–0.95, <i>p</i> = 0.03), shorter length of hospital stay (OR = −0.72, 95% CI −1.44 to −0.00, <i>p</i> = 0.05), better FEV1 (mean difference = 0.14, 95% CI 0.08–0.20, <i>p</i> &#x3c; 0.00001), and a lower risk of arrhythmias (OR = 1.50, 95% CI 1.01–2.21, <i>p</i> = 0.04). In addition, the non-EOS group had a higher percentage of male (OR = 1.34, 95% CI 1.15–1.56, <i>p</i> = 0.0002) than EOS group. The rate of steroid use (OR = 0.82, 95% CI 0.47–1.42, <i>p</i> = 0.48) and BMI (mean difference = 0.43, 95% CI −0.18 to 1.05, <i>p</i> = 0.17] had no difference between 2 groups. <b><i>Conclusion:</i></b> The results of our meta-analysis suggest that EOS AECOPD patients have a better clinical outcome than non-EOS AECOPD patients in terms of length of hospital stay, in-hospital mortality, FEV1, and risk of arrhythmias. In addition, the non-EOS AECOPD patients have higher percentage of male than EOS AECOPD patients.

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