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Predictors of hospitalization in patients presenting to emergency department with an acute exacerbation of COPD – a single-center study in Turkey

100%
Sanalp Menekşe T., Taha Sert E.
European Journal of Clinical and Experimental Medicine
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2023
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issue 3
561-566
EN
Introduction and aim. In this study, we evaluated parameters that might be associated with hospitalization in patients admitted to the emergency department (ED) with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material and methods. Patients with COPD who presented to ED due to AECOPD between January 1, 2020 and December 31, 2021 were included in the study. Patient data were obtained from the hospital database. Univariable and multivariable logistic regression methods were used to identify the relationship between hospitalization and clinical parameters. Results. The study included 237 patients divided into two groups: inpatients (n=124) and outpatients (n=113). We found significant differences between the two groups in terms of temperature, oxygen saturation, respiratory rate, C-reactive protein, white blood cell count, procalcitonin, albumin, arterial blood pH, pCO2, and non-invasive mechanical ventilation (NIMV) requirement. Multivariable logistic regression analysis showed that body temperature [odds ratio (OR):1.62;95% confidence interval (CI):1.21–4.91; p<0.001], oxygen saturation (OR:0.73, 95% CI:0.39-0.94, p<0.001), respiratory rate (OR:1.96; 95% CI: 1.07–6.14; p<0.001), albumin (OR:0.71; 95% CI:0.41–0.93; p=0.042), procalcitonin (OR:2.93; 95% CI:1.22–4.84; p<0.001), arterial blood pH (OR:0.78; 95% CI:0.29-0.91; p=0.038), pCO2 (OR:2.45; 95% CI:1.24–4.65; p<0.001), and NIMV requirement (OR:2.31; 95% CI:1.41–5.13; p<0.001) were the independent predictors of hospitalization. Conclusion. Our findings may help identify patients who will require hospitalization at an early stage.
2
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Correlation of the end-tidal CO2 value with arterial blood gas parameters – evaluation of the treatment efficacy of COPD exacerbation in the emergency department

88%
Çakmak F., Tekin E.
European Journal of Clinical and Experimental Medicine
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2022
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issue 3
316-322
EN
Introduction and aim. Painful, invasive, and expensive arterial blood gas (ABG) analysis is required in the diagnosis, follow-up, treatment, and even discharge of patients with chronic obstructive pulmonary disease (COPD). This study aimed to compare the end-tidal carbon dioxide (ETCO2) value, which allows non-invasive, painless, low-cost, and continuous monitoring, with ABG parameters, in the evaluation of the treatment efficacy of COPD exacerbation. Material and methods. The study was prospectively conducted with patients who presented to the emergency department with COPD exacerbation. ABG analysis and ETCO2 measurement were simultaneously performed in patients with COPD exacerbation at the time of arrival and after treatment, and were statistically compared. Results. The study included a total of 216 patients, of whom 57.4% were male. The mean age of the patients was 67.3±13.9 years. The ETCO2 values of the patients at arrival and after COPD exacerbation treatment were 39.2±10 and 37.3±9, respectively, and a statistically significant difference was determined (p=0.001). The partial pressure of pCO2 values measured at arrival and after treatment were 40.85±10.54 and 38.74±9.25, respectively, and it was statistically significant (p=0.001). A strong positive and statistically significant correlation was found between the ETCO2 and pCO2 values both at arrival and after COPD exacerbation treatment (r=0.840; p<0.001 and r=0.872; p<0.001, respectively). The Bland-Altman plot was constructed for the agreement between ETCO2 and pCO2 at both evaluation times. Conclusion. ETCO2 measurement could accurately predict the pCO2 of patients with COPD at arrival and after COPD exacerbation treatment. Also, ETCO2 may be useful in cases where pCO2 cannot be used.
3
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The correlation between death anxiety and anxiety in elderly with chronic obstructive pulmonary disease

75%
Nal B., Aydın Avcı I., Ayyildiz M.
Progress in Health Sciences
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2016
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vol. 6(1)
63-69
EN
Purpose: This study aims to determine the correlation between death anxiety and anxiety in elderly patients with chronic obstructive pulmonary disease. Materials and methods: This study has been conducted on the individuals with chronic obstructive pulmonary disease (COPD) who were over 65 years. They received outpatient and inpatient treatment at a hospital. 171 elderly persons that were determined via power analysis were included in the research. Data was collected using a survey form, Death Anxiety Scale, State Anxiety Scale, and Trait anxiety scale. We used the following test statistics: t-test, ANOVA and Kruskal-Wallis Variance Analysis, and Pearson Correlation Test analysis. Results: 66.1 percent (113) of the participants are male and 33.9%(58) female; mean age is 726.83. The mean death anxiety score of the participants is 9.044.02. The mean State Anxiety score of elderly individuals with chronic obstructive pulmonary disease is 44.81.29; the trait anxiety mean score is 48.851.13. In those chronic obstructive pulmonary disease patients, we found a significant (p<0.001) correlation between state and trait anxiety, and that the latter two are high in cases where death anxiety is high. Conclusion: We found that death anxiety and anxiety are high in patients with COPD.
4
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Spirometric and hygienic criteria in recognition of occupational COPD in Poland – A retrospective analysis of medical records

75%
Kleniewska A., Walusiak-Skorupa J., Lipińska-Ojrzanowska A., Szcześniak K., Wiszniewska M.
International Journal of Occupational Medicine and Environmental Health
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2017
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vol. 31
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issue 2
139-150
EN
Objectives: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment – clinical or hygienic one – is responsible for such a low rate of occupational COPD recognitions. Material and Methods: The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases. Results: In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients. Conclusions: In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139–150
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Ocena wiedzy lekarzy na temat przewlekłej obturacyjnej choroby płuc pochodzenia zawodowego

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Kleniewska A., Walusiak-Skorupa J., Piotrowski W., Marcinkiewicz A., Szcześniak K., Wiszniewska M.
Medycyna Pracy
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2016
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vol. 67
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issue 3
375-384
EN
Background Chronic obstructive pulmonary disease (COPD) may be induced by the work environment conditions. According to the estimates, 10–20% of all COPD cases are associated with occupational exposure to dusts and irritant gases. However, in 2014, only 11 cases of work-related COPD were recognized in Poland. The aim of the study was to analyze the reasons for the low incidence of work-related COPD in the context of pulmonologists’ knowledge about occupational risk factors and procedures on reporting suspected occupational diseases. Material and Methods A survey included 94 pulmonologists randomly selected out of 225 specialists registered at the Local Physicians Chamber in Łódź. The study was performed anonymously with the use of original questionnaire. Results More than a half of the surveyed pulmonologists identified environmental risk factors for COPD correctly, while only 23.4% properly identified the main occupational risk factors as the cause of COPD. Only 58.5% of the pulmonologists always asked their patients suffering from COPD about their job/profession and 60.6% of them did not have any knowledge about procedures on reporting suspected occupational diseases. Conclusions The physicians rarely ask patients suffering from COPD about their job/profession and the relationship between their ailments and occupational exposure. What is more, they do not know legal regulations on proper referral of a patient with a suspected case of occupational disease. The results of the study clearly indicate that there is an urgent need for increasing pulmonologists’ knowledge on work-related COPD. Med Pr 2016;67(3):375–384
PL
Wstęp Przewlekła obturacyjna choroba płuc (POChP) może być wywołana warunkami środowiska pracy. Według szacunkowych danych 10–20% wszystkich przypadków POChP ma związek z zawodowym narażeniem na pyły i gazy drażniące. Jednocześnie w 2014 r. w Polsce rozpoznano jedynie 11 przypadków POChP pochodzenia zawodowego. Celem pracy była analiza zależności między niewielką liczbą rozpoznawanej POChP o etiologii zawodowej a wiedzą lekarzy na temat czynników etiologicznych choroby związanych z narażeniem zawodowym oraz znajomości procedur związanych ze zgłaszaniem podejrzenia choroby zawodowej. Materiał i metody Badaniem ankietowym objęto 94 lekarzy pulmonologów losowo wybranych spośród 225 specjalistów chorób płuc zarejestrowanych w Okręgowej Izbie Lekarskiej w Łodzi. Metodą badawczą była autorska anonimowa ankieta. Wyniki Większość ankietowanych pulmonologów prawidłowo określiło środowiskowe czynniki mogące wywoływać POChP, jednocześnie tylko 23,4% wskazało prawidłowo podstawowe czynniki pochodzenia zawodowego jako przyczynę POChP. Jedynie 58,5% pulmonologów zawsze pyta pacjentów z POChP o wykonywany zawód, a 60,6% z nich nie miało wiedzy na temat procedur związanych ze zgłaszaniem podejrzenia choroby zawodowej. Wnioski Lekarze mają niepełną znajomość czynników zawodowych mogących wywoływać POChP, nie zawsze pytają chorych na POChP o wykonywany zawód i związek dolegliwości z wykonywaną pracą, a także nie znają regulacji prawnych dotyczących prawidłowego skierowania pacjenta z podejrzeniem choroby zawodowej do jednostki orzeczniczej. Wyniki przeprowadzonych badań wskazują na potrzebę zwiększania wiedzy lekarzy w zakresie zagadnień związanych z przewlekłą obturacyjną chorobą płuc pochodzenia zawodowego. Med. Pr. 2016;67(3):375–384
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