ANALYSIS OF THE PATIENTS ADMITTED TO OUR EMERGENCY DEPARTMENT DUE TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATION
Objective: Chronic Obstructive Pulmonary Disease (COPD) is the fourth most common cause of death in the world according to the reports of the World Health Organisation (WHO). Exacerbations impair the quality of life, fastens the progression of the disease and, thus, plays an important role in the morbidity and mortality of the disease. In this study with, we aimed to investigate the factors effecting the characteristics of the patients admitted to our emergency department (ED) due to COPD exacerbation in term of management, dischargement, hospitalization and death.
Method: This retrospective study was approved by the Local Ethic Comitee of Ankara Numune Education and Research Hospital. This study consists of 106 patients with diagnosis of COPD.
Results: Into our study, 106 patients were included. Of these patients, 58 were male and 48 were female, and mean age was 67.62±11.67. 56 of our patients expressed that they were active smokers, 19 expressed that they gave up smoking and 56 expressed that they have never smoke. In the last year, mean number of exacerbations was 10.1±6.1. While 50 (47.2%) patients were discharged from the ED, others were hospitalized or transferred to other hospitals. 15 patients were transferred to the ICU. Mean age of these patients was 76.13±12.03 (p= 0.002). 8 patients admitted to the ICU were smokers and mean smoking period was 42.88 ± 7.58 years. Inpatients not transferred to the ICU, this period was 35.26±11.12 years (p= 0.035). In the ED and ICU 11 deaths (10.37%) occured. 9 patients did not know the drugs they use at home (p= 0.026). Exacerbation frequency in the past year was 14.45 ± 5.7 (p= 0.008). 1 patient who died had undergone NIMV followed by IMV and 10 patients had undergone IMV. None of the patients in our study were vaccinated. We determined that smoking is the most important ethiological factor.
Conclusion: We also determined that main target to reduce the frequency of annual exacerbations is patient education and patient concordance. When compared to mono therapy, combined inhaler therapy reduced the frequency of exacerbations and increases the rate of discharge
Fuat Kulaksız 1, Engin Deniz Aslan 1, Ali Kemal Erenler 2,
Murat Muratoglu 3, Cemil Kavalci 3
1 Ankara Numune Training and Research Hospital, Emergency Department, Ankara, Turkey;
2 Hitit University Çorum Education and Research Hospital Emergency Department Çorum, Turkey;
3 Baskent University Faculty of Medicine Emergency Department, Ankara, Turkey.
1. Erdinç E., Polatlı M., Kocabaş A. et al. 2010 Türk Toraks Derneği Kronik Obstrüktif Akciğer Hastalığı Tanı ve Tedavi Uzlaşı Raporu // Turkish Thorasic journal 2010;11 (Supp 1):1-64
2. Kavalci C., Yilmaz M.S., Kayipmaz A.E., et al. Correlation of CAT Score With Peak Expiratory Flow in Acute Exacerbation of COPD Patients // J Natl Med Assoc. 2016;108(3):164-168. doi: 10.1016/j.jnma.2016.06.002
3. Mannino D.M., Homa D.M., Akinbami L.J., et al. Chronic obstructive pulmonary disease surveillance – United States, 1971-2000 // MMWR Surveillance Summary 2002;51:1-16.
4. Günen H., Hacıevliyagil S.S., Kosar F., et al. Factors affecting survival of hospitalized patients with COPD // European Respiratory Journal 2005;26:234-41.
5. Soto F.J., Varkey B. Evidence-based approach to acute exacerbations of COPD // Current Opinion in Pulmonary Medicine 2003;9:117-24.
6. Barr R.G., Bourbeau J., Camargo C.A. Tiotropium for stable chronic pulmonary disease // Cochrane Database System Reviev 2005;Issue 2. Art. No:CD002876.
7. Stoller J.K. Acute exacerbation of chronic obstructive pulmonary disease // New England Journal of Medicine 2002;13:988-94.
8. Sullivan S.D., Ramsey S.D., Lee T.A. The economic burden of COPD // Chest 2000;117:5-9.
9. Donaldson G.C., Wedzicha J.A. COPD exacerbations: Epidemiology // Thorax 2006;61:164-68.
10. Mirawitlles M., Anzueto A., Legnani D., et al. Patients’s perception of exacerbations COPD-the PERCEIVE study // Respiratory Medicine 2007;101: 453-60.
11. Haughney J., Partridge M.R., Vogelmeier C., et al. Exacerbations of COPD: quantifying the patient’s perspective using discrete choice modeling // Europian Respiratory Journal 2005;26:623-29.
12. Mannino D.M. Chronic obstructive pulmonary disease: definition and epidemiology // Respiratory Care 2003;48:1185-91.
13. Doll R., Peto R., Boreham J., Sutherland I. Mortality in relation to smoking: 50 years observations on male British doctors // British Medical Journal 2004;328:1519-1527.
14. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, U.S. department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004. https://www.ncbi.nlm.nih.gov/books/NBK44695/pdf/Bookshelf_NBK44695.pdf. (last access date 28/01/2019)
15. Eagan T.M., Gulsvik A., Eide G.E., Bakke P.S. Remission of respiratory symptoms by smoking and occupational exposure in a cohort study // European Respiratory Journal 2004;23:589-94.
16. O’Donnell D.E., Aaron S., Bourbeau J., et al. Canadian Thoracic Society Recommendations for management of chronic obstructive pulmonary disease-2007 update // Canadian Respiratory Journal 2007;14:5B-32B.
17. Rennard S., Decramer M., Calverley P.M., et al. Impact of COPD in North America and Europe in 2000: subjects perspective of Confronting COPD International Survey // European Respiratory Journal 2002;20:799-805.
18. Appleton S., Poole P., Smith B., et al. Long-Acting β2-agonists for poorly reversible chronic obstructive pulmonary disease // Cochrane Database Syst Rev. 2006;(3):CD001104. Review.
19. Lung Health Study Research Group. Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease // The New England Journal of Medicine 2000;343:1902-90.
20. Burge P.S. EUROSCOP, ISOLDE and Copenhagen City Lung Study // Thorax 1999;54:287-88.
21. Kardos P., Wencker M., Glaab T., Vogelmeier C. Impact of salmeterol/fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease // American Journal of Respiratory and Critical Care Medicine 2007;175:144-49.
22. Calverley P.MA, Anderson J.A., Celli B., et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease // New England Journal of Medicine 2007;356:775-89.
23. Sidney S., Sorel M., Qensenberry C.P., et al. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program // Chest 2005;128:2068-75.
24. Boutin-Forzano S., Moreau D., Kalaboka S., et al. Reported prevalence and co-morbidity of asthma, chronic bronchitis and emphysema: a pan-European estimation // International Journal of Tuberculosis and Lung Disease 2007;11: 695-702.
Количество просмотров: 854
Категория статей:
Оригинальные исследования
Библиографическая ссылка
Fuat Kulaksız, Engin Deniz Aslan, Ali Kemal Erenler, Murat Muratoglu, Cemil Kavalci Анализ пациентов, поступивших в отделение неотложной медицины в связи с обострением хронической обструктивной болезни легких // Наука и Здравоохранение. 2019. 1 (Т.21). С. 50-57. Fuat Kulaksız, Engin Deniz Aslan, Ali Kemal Erenler, Murat Muratoglu, Cemil Kavalci Analysis of the patients admitted to our emergency department due to chronic obstructive pulmonary disease exacerbation. Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 1, pp. 50-57. Fuat Kulaksız, Engin Deniz Aslan, Ali Kemal Erenler, Murat Muratoglu, Cemil Kavalci Өкпенің созылмалы обструктивті ауруының асқынуына байланысты шұғыл медицина бөліміне түсетін пациенттердің талдауы // Ғылым және Денсаулық сақтау. 2019. 1 (Т.21). Б. 50-57.Похожие публикации:
МЕХАНИКАЛЫҚ САРҒАЮ ОПЕРАЦИЯСЫ КЕЗІНДЕ КОАГУЛОПАТИЯЛЫҚ ҚАН КЕТУДІҢ АЛДЫН АЛУ ӘДІСІ
ОПТИМИЗАЦИЯ РЕЗУЛЬТАТОВ АУТОДЕРМОПЛАСТИКИ ПРИ ЛЕЧЕНИИ ГРАНУЛИРУЮЩИХ ГНОЙНЫХ РАН
BASICS OF REHABILITATION OF CHILDREN AFTER OPERATIONS ON THE COLON AND ANORECTAL AREA
HEALTH INDICATORS OF FIRST-YEAR-OF-LIFE CHILDREN IN THE REPUBLIC OF KAZAKHSTAN FOR 2013-2022
ОЦЕНКА УДОВЛЕТВОРЕННОСТИ ТРУДОВОЙ ДЕЯТЕЛЬНОСТЬЮ ВРАЧЕЙ АНЕСТЕЗИОЛОГОВ-РЕАНИМАТОЛОГОВ ГОРОДА АСТАНА