PURPOSE: Military personnel deployed to the theaters of operation in Southwest Asia are exposed to a variety of environmental and physical stressors that can potentially worsen or provoke COPD. This study seeks to establish the relationship between the diagnosis of COPD and the onset of symptoms/exacerbations to deployment.
METHODS: A retrospective chart review was conducted of all active duty military personnel who were diagnosed with COPD from 2005 to 2009 and had a minimum of three outpatient evaluations. The Department of Defense electronic medical record was reviewed to determine the following parameters: date of diagnosis, temporal relationship to deployment, symptoms (pre and/or post deployment), severity of disease, spirometric parameters [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio], smoking history, radiographic findings, pulmonary medications, and overall control of disease.
RESULTS: A list of 1033 patients was generated from querying the military electronic medical record system for diagnoses of COPD between the years 2005 and 2009. One-hundred fifty-four patients had spirometry as part of their evaluation. The average age of the patients was forty-five years old. The mean pack year tobacco history equaled twenty. Forty-two patients (27%) had been deployed and only two patients had a pre-existing diagnosis of COPD. The remaining patients (95%) were diagnosed after deployment on the basis of increased symptoms
CONCLUSIONS: Review of ICD-9 codes for COPD did not correlate with a clinical and spirometric diagnosis of COPD in active duty military as the majority of patients had no documented spirometry. Nearly 75% of active duty military members with an established diagnosis had not deployed during the current conflicts. Of those who deployed, the majority were diagnosed post-deployment.
CLINICAL IMPLICATIONS: The impact of COPD and development of COPD in active duty members with a deployment history appears to be very small.
DISCLOSURE: The following authors have nothing to disclose: Tokunbo Matthews, Michael Morris
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