Prognostic factors associated with acute exacerbation in chronic obstructive pulmonary disease patients

Abstract

Background : Chronic obstructive pulmonary disease (COPD) is an important public health problem worldwide as it is the leading cause of morbidity and mortality. In Thailand, the incidence of COPD is increasing      each year and the occurrence of acute exacerbation of COPD is a burden to public health identify and examine the quality of life of patients.

Objective :     To study  prognostic factors associated with acute exacerbation in COPD patients and to examine study the mean difference in the incidence of acute exacerbation in COPD patients that were classified by COPD GOLD group A, B, C and D.

Study deign :  Prognostic factor research, exploratory analysis, retrospective cohort studies, conducted study at emergency room, medical ward and COPD clinic at Phrae hospital. COPD patients who continuously followed up in COPD clinic from October 2019 to September 2020, consisting of 270 patients COPD patients were devided into two groups with prognostic factor related acute exacerbation and the group without prognostic factor. Then monitor the incidence of acute exacerbation in each group. Compare risk of acute exacerbation in each prognostic factor using multivariable log risk regression.

Result :          Acute exacerbation in COPD patient with pneumonia during 1 year and previous acute exacerbation last year were at risk 4.626  and  4.414 times , respectively, when compared to patient without that factors with statistical significant (95% CI; 2.837-7.400 and  2.759 – 7.198 respectively) and when adjusting the influence of age, gender, body mass index, smoking, diabetes mellitus, hypertension, myocardial infarction, heart failure, bronchiectasis, bronchitis and pneumonia

Conclusion:   Pneumonia and more severe stage of COPD  are more likely higher risk to have acute exacerbation. Therefore the COPD patients should be concern and need to be advised to prevent acute exacerbation

Keyword:       chronic obstructive pulmonary disease, Acute exacerbation, COPD group