PURPOSE: Several internationally accepted guidelines have been published on diagnosis and assessment of severity of COPD in recent years. This includes GOLD and NICE guidelines. COPD should be diagnosed clinically and confirmed as well as staged by spirometry whenever possible. Heretofore, spirometry was not available at Sher-e-Bangla Medical College Hospital (SBMCH), Barisal, the largest teaching hospital in southern Bangladesh. The establishment of the respiratory unit and placement of pulmonologists has made spirometry available at SBMCH thereby facilitating the optimum diagnosis and staging of COPD patients.
METHODS: A 9 month long prospective cross sectional observational study was done to diagnose and assess severity of COPD based on aforesaid guidelines. Patients admitted in medicine department of SBMCH with symptoms suggestive of COPD were assessed clinically. A clinical diagnosis of COPD was made and spirometric evaluation was done for confirmation of clinical diagnosis and staging. In addition to step care management, patients were given anti-tobacco counseling.
RESULTS: A total of 322 patients were suspected clinically and confirmed subsequently via spirometry as COPD. Their severity was recorded as per guideline of GOLD/NICE 2010. Both guidelines have similar staging. The series showed 30.9%, 33.9% & 35.2% patients in stage II, III & IV respectively.
CONCLUSIONS: Spirometric diagnosis and staging facilitates the appropriate evidence based management of COPD patients admitted in SBMCH, Barisal, the largest teaching hospital in southern region of Bangladesh
CLINICAL IMPLICATIONS: we can use it to for good management of COPD
DISCLOSURE: The following authors have nothing to disclose: Md Siddiqur Rahman
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