Trends in the presentation of acute exacerbation of chronic obstructive pulmonary disease requiring admission to ICU: Experience at a tertiary care teaching hospital in South India

Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) worsens the respiratory symptoms that are usually triggered by infection with bacteria or viruses or by environmental pollutants. Therefore, the aim of this study was to determine the bacterial etiology from sputum culture in patients suffering from acute exacerbation of COPD, admitted in hospital. Methods: The study was cross sectional observational, where sputum bacterial cultures were analyzed from the patients with Acute exacerbation COPD treated in the ICU of a tertiary care hospital for pulmonary disease from January 2019 to December 2019. Two sputum samples were collected from each patient for bacterial examination. The results of sputum bacterial culture ﬁndings were expressed as frequency and percentage by using SPSS. Results: In the present study, there were 1296 patients, both males 749 (57.8%) and females 547 (42.2%). The mean age of patients was 57.39±19.74years. 470 (36.3%) showed negative culture reports. 440 (34.0%) patients had Moraxella infection, which was most common organism in all patients, and 149 (11.5%) patients had Pseudomonas infection, 157(12.1%) patients had Yeast Albicans and in only 1 (0.1%) patient Enterobacter infection were found. Other pathogens in low frequency identiﬁed were Haemophilus parainfluenzae, Streptococcus pneumoniae, Escherichia coli and Haemophilus influenzae. It was observed that the frequency of infections was linked with increasing age. Conclusion: With increasing age, people are prone to acquire pulmonary infections speciﬁcally COPD. It is therefore very important to perform sputum culture to identify the causative agents and treat the patients with appropriate antibiotic to reduce the episodes of AECOPD. Keywords: Bacteria; Sputum Culture; COPD; Antibiotic; Cough.

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Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172467 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2669

Author(s):

Seema Gupta ◽

Varinder Saini ◽

Jasbinder Kaur ◽

Shivani Jaswal ◽

Harjeet Kaur ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Cardiac Troponin ◽

Troponin I ◽

Tertiary Care ◽

Cardiac Troponin I ◽

Chronic Obstructive ◽

Care Hospital ◽

Obstructive Pulmonary Disease

Background: Comorbidities are important determinants of outcome and quality of life of patients with chronic obstructive pulmonary disease (COPD). The risk of cardiovascular events in COPD patients is three to five-fold high. COPD is often associated with right ventricular hypertrophy and pulmonary hypertension. Various studies have associated levels of cardiac troponin I (cTnI) with severity and duration of acute exacerbation of COPD (AECOPD). The objective of the present study was to assess the usefulness of serum cTnI as mortality predictor in AECOPD patients.Methods: An observational, prospective and non interventional study was conducted in 50 patients with AECOPD admitted in the pulmonary medicine emergency or ward of a tertiary care hospital of Northern India. AECOPD was diagnosed according to Global Initiative for chronic obstructive lung disease guidelines. cTnI levels were estimated within 24 hours of admission by method based on chemiluminiscence along with routine investigations. Levels ≥ 0.01ng/ml were taken as positive. The patients were followed up for 30days for outcome in terms of mortality and morbidity. Data was entered and analyzed by SPSS package and two sided p values<0.05 were considered statistically significant.Results: The serum cTnI was found to be positive in 34% of patients with AECOPD. The in- hospital mortality was significantly low in patients having cTnI <0.01ng/ml as compared to patients with cTnI ≥0.01ng/ml. The patients with cTnI levels ≥0.01ng/ml had significantly higher mean PaCO2 levels and higher requirement for invasive or noninvasive ventilation during hospital stay as compared to patients having cTnI <0.01ng/ml (p=0.04 and 0.016 respectively).Conclusions: Levels of cTnI≥0.01ng/ml may be considered as a biomarker to predict mortality in AECOPD patients.

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