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Obstructive Lung Diseases |

Assessment of Clinical Features and Pulmonary Functions Associated With Frequent Acute Exacerbations in COPD Patients

Prem Parkash Gupta, MD; Rohtas Yadav, MD; Manjunath Govindagoudar, MBBS; Dipti Agarwal, MD
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Dept. of Respiratory Medicine, PGIMS, Rohtak, India


Chest. 2013;144(4_MeetingAbstracts):678A. doi:10.1378/chest.1696314
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Abstract

SESSION TITLE: Acute exacerbations of COPD

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PM

PURPOSE: To assess clinical characteristics and pulmonary functions parameters including spirometric indices and transfer test associated with frequent acute exacerbations in COPD patients.

METHODS: The study included 80 COPD patients of whom 40 patients had ≥ 2 acute exacerbations during preceding one year (FECOPD Group), and 40 patients had < 2 acute exacerbations during preceding one year (I-FECOPD Group); the division was done as per ECLIPSE study. Patients` clinical data was collected. Sputum microbiology, blood gas analysis, spirometric indices and transfer test variables were studied in both groups.

RESULTS: The age of patients in FECOPD group and I-FECOPD group was 60.15±11.19 year and 62.28±7.83 year, respectively. The mean expectoration scores were 2.20±1.14 and 1.08±1.10 in the FECOPD group and I-FECOPD group, respectively. Cough score and wheeze score did not differ significantly between two groups. MMRC dyspnea scores were 2.28±0.91 and 1.68±1.05 in FECOPD and I-FECOPD groups, respectively. The mean duration of illness was 11.45±5.34 year in FECOPD and 9.36±5.89 year in I-FECOPD groups. Arterial blood gas analyses revealed significantly decreased PO2 & SaO2 and increase in PCO2 in FECOPD group. 12 patients in FECOPD group and 4 patients in I-FECOPD group had lower airway colonization by bacteria. FEV1 was significantly reduced in FECOPD group (1.27±0.42 L vs. 1.66±0.43 L). DLCO values were significantly reduced in FECOPD group (16.15±5.88 ml/mmHg/min vs. 18.86±5.03 ml/mmHg/min). KCO values were also significantly reduced in FECOPD group (3.35±1.18 ml/mmHg/min/L vs. 3.85±1.02 ml/mmHg/min/L).

CONCLUSIONS: We observed that clinical characteristics, arterial blood gas analysis, bacterial colonization pattern, spirometric indices and transfer test parameters were suggestive of a distinct COPD phenotype more prone to have COPD frequent acute exacerbation.

CLINICAL IMPLICATIONS: The identification of clinical and lung function parameters that are linked to COPD acute exacerbation shall help in predicting future exacerbations more confidently and this will also help in prevention and better management of acute exacerbations in these patients.

DISCLOSURE: The following authors have nothing to disclose: Prem Parkash Gupta, Rohtas Yadav, Manjunath Govindagoudar, Dipti Agarwal

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