Obstructive Lung Diseases |

Clinical Characteristics and Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease FREE TO VIEW

Hamdy Mohammadien, MD; Azza Ahmed, MD
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Sohag University-Sohag Faculty of Medicine, Sohag-Elmaragha-Nagecc Elhakim, Egypt

Chest. 2015;148(4_MeetingAbstracts):723A. doi:10.1378/chest.2229753
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are associated with a decline in lung function, increased risk of hospitalization, and incur significant costs, which include antibiotic costs and mortality. The purpose of this study is to assess the clinical characteristics and Outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

METHODS: Four hundred patients hospitalized with Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were included. Hemogram, biochemical tests,C-reactive protein (CRP) levels and arterial blood gases, 6 min walk distance,modified MRC dyspnea scale,BODE index score,Pulmonary function tests were analyzed.

RESULTS: 400 patients (70% male) with a mean age of 59.2 ± 12.8 years were included.Patients with frequent AE had a significantly lower FEV1(p < 0.005), BMI(p < 0.0001), and 6MWD(p < 0.0001),old age (p < 0.005), chronic cough & sputum production(p < 0.0001), higher mMRC (p < 0.001), BODE index(p < 0.0001), & serum CRP (p < 0.0001),compared to patients with infrequent AE. P.aeruginosa and Enterobacteriaceae were significantly associated with severe &very severe airway obstruction (p = 0.002).Mortality & ICU admission were significantly higher in older patients (p < 0.0001), respiratory failure (p < 0.004), decompensated cor pulmonal (p < 0.04), lower FEV1 (p < 0.0001), and high CRP (p < 0.05). There were significant negative correlations between number of exacerbations and FEV1(p < 0.001), 6MWD (p < 0.001),and BMI (p < 0.001), and There were also significant positive correlations between number of COPD-AE and BODE index(p < 0.001), CRP(p < 0.001), age (p ˂0.001) and dyspnea scale (p <0.001). However,there was no significant association with sex and outcame. Serum CRP was significantly lower on discharge (53±61.2) compared with admission (71±82.3), (p < 0.002). Also serum CPR was significantly higher in patients with purulent sputum than in patients with mucoid sputum (p < 0.0001).

CONCLUSIONS: we found that FEV1, CRP, BODE index, mMRC scale, BMI and chronic mucous hypersecrations,were the most significant predictor of frequency of COPD-AE.old age, resp. failure,DCP, severe &very severe airway obst. and high CRP were associated with higher Mortality & ICU admission.

CLINICAL IMPLICATIONS: FEV1, CRP, BODE index, mMRC scale, BMI,chronic mucous hypersecrations, age,DCP and respiratory failure can be used to predict frequency of COPD-AE, ICU admission and mortality in COPD patients with AE.

DISCLOSURE: The following authors have nothing to disclose: Hamdy Mohammadien, Azza Ahmed

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