scholarly journals Predictors of mortality in patients of acute exacerbation of chronic obstructive pulmonary disease: A prospective observational study

2018 ◽  
Vol 7 (2) ◽  
pp. 77 ◽  
Author(s):  
Satyadeo Choubey ◽  
Hemant Kumar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Observational Study ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Predictors Of Mortality

Application of BAP-65 Score for Risk Stratification of Acute Exacerbation of Chronic Obstructive Pulmonary Disease - A Prospective Observational Study in a Tertiary Care Institute in Telangana

2021 ◽  
Vol 8 (29) ◽  
pp. 2667-2673
Author(s):  
Deepika Shree Balaram ◽  
Narendra Kumar Narahari ◽  
Bhaskar Kakarla ◽  
Rajasekhar Varma Gande ◽  
Paramjyothi Kruparao Gongati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Observational Study ◽  
Risk Stratification ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Group 4

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a significant morbidity and mortality with a need for frequent hospitalizations and mechanical ventilation. Thus, a model was searched that required simple information that was consistently available in emergency department, upon the presentation of the patient which allowed risk stratification and to identify patients who might potentially benefit from early intervention. METHODS This was a prospective observational study conducted over a period of 6 months, from May 2018 to December 2018 with a study sample of 136 patients. The primary objective was aimed to validate the BAP-65 score system in predicting the need for ventilatory support and mortality in patients who presented with acute exacerbation of COPD. RESULTS Mean age of the study population was 64.13 ± 9.7 and 29 (21.32 %) were females with obvious male predominance. It was observed that as the BAP-65 score increases, the mortality increases. Mortality among the score groups 0, 1 and 2 was one, zero, one respectively. The mortality is about 37.5 % in the score group 3 and it increased to 90.9 % in the score group 4. The patients who needed mechanical ventilation were about 4 % in the score group 2 and it increased to 100 % in the score group 4. BAP-65 scoring system had a sensitivity of 88.89 % and specificity of 90.68 % in predicting the in-hospital mortality, and a sensitivity of 84 % and specificity of 94.59 % in predicting the need for mechanical ventilation during hospital stay. CONCLUSIONS The BAP-65 scoring system seems to be a promising tool which is simple and accurate. The score correlated well with both the mortality and also the need for mechanical ventilation, thus helping in decision making at triage level and also in prognostication of the disease. KEYWORDS Chronic Obstructive Pulmonary Disease, Acute Exacerbation, BAP-65, AECOPD, Mortality, Mechanical Ventilation

scholarly journals A prospective observational study on acute exacerbation of chronic obstructive pulmonary disease in pulmonology department of tertiary care hospital

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Sreenu Thalla ◽  
Akhila Yerubandi ◽  
Sk. Hafeezunnisa ◽  
Sk. Jareena ◽  
Sivakshari Makkapati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Observational Study ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Acute Exacerbations ◽  
Exacerbation Of Copd

Abstract Background Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gasses. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. Acute exacerbation in COPD (AECOPD) is frequent in the course of the illness and is the most common reason for medical visits, hospital admissions, and mortality among these patients. Exacerbations of COPD are associated with increased morbidity and mortality. To assess the exposure and severity of acute exacerbations of COPD with COPD Assessment Test (CAT Scale) and mMRC (modified Medical Research Council) Dyspnea scale. Study design was a hospital-based prospective observational study. Study site was conducted at Pulmonology Department of Government General Hospital, Vijayawada. Results The total patients were 197. Out of which, 119 were from In-patient Department (IPD) and 78 were from Out-patient Department (OPD). In this study, males were 167 (85%), among which, IPD were 97 (49%), OPD were 70 (36%), and females were 30 (15%), among which, IPD were 22 (11%), OPD were 8 (4%). Conclusion The morbidity and mortality of COPD have been increased in recent years. This study concludes that there is a relation between risk of acute exacerbations in COPD with habitual history and occupational history. Increase in exposure to occupational hazards, smoking habit leads to an increase in risk of acute exacerbations in COPD patients. The level of severity was more in smokers and the patients who had biomass, organic dust, and mineral exposure. When severity was observed, group D severity is more observed in population according to CAT scale and mMRC dyspnea scale.

Prospective observational study of respiratory Aspergillus colonization or disease in patients with various stages of chronic obstructive pulmonary disease utilizing culture versus nonculture techniques

2020 ◽  
Author(s):  
Sarmad Waqas ◽  
Katie Dunne ◽  
Alida Fe Talento ◽  
Graham Wilson ◽  
Ignacio Martin-Loeches ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Observational Study ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Fungal Culture ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Chronic obstructive pulmonary disease (COPD) patients have been recognized to be at increased risk of Aspergillus spp. colonization, which may progress to invasive pulmonary aspergillosis (IPA). The objective of this study was to determine the frequency of Aspergillus colonization, or disease, in a cohort of COPD patients. A prospective observational study was undertaken to determine Aspergillus colonization, or disease, in consecutive COPD patients undergoing bronchoscopy. Fungal culture as well as galactomannan antigen (GM) and Aspergillus nucleic acid detection (PCR) were performed on bronchoalveolar lavage fluid (BAL) samples. One hundred and fifty patients were recruited. One hundred and twelve (74.7%) were outpatients, 38 (25.33%) were inpatients, of whom 6 (4%) were in the intensive care unit. Most patients (N = 122, 81.3%) were either COPD GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages 1 or 2. Nine (6%) patients were on systemic steroids, 64 (42.7%) on inhaled steroids, and 9 (6%) on both. Seventeen patients (11.3%) had at least one positive test for Aspergillus detection (culture ± galactomannan ± polymerase chain reaction [PCR]), 13 (76.4%) of whom were COPD GOLD stages 1 or 2.  Five patients had probable or putative IPA. Aspergillus sp. was detected in five patients (3.3%) by culture, but detection increased to 17 (11.3%) by the additional testing for GM or Aspergillus DNA. The frequency of Aspergillus detection in this cohort of COPD patients may reflect the predominance of early GOLD stages among the study population but deserves further investigation to determine its relevance as a predictive risk factor for IPA. Lay Summary COPD is a risk factor for Aspergillus spp. colonization. Bronchoalveolar lavage samples of 150 COPD patients were tested for presence of Aspergillus fumigatus, which was detected in five patients (3.3%) by culture, but detection of Aspergillus increased to 17 (11.3%) by additional GM and PCR testing.

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