KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA ATAK PROFİLİ: RETROSPEKTİF ÇALIŞMA
Year 2021,
, 44 - 48, 31.08.2021
Özge İpek Dongaz
,
Dilara Özen Oruk
,
Asalet Aybüke Güp
,
Özge Oral Tapan
,
Banu Bayar
,
Kılıçhan Bayar
Abstract
Amaç: Kronik obstrüktif akciğer hastalığı (KOAH), ciddi mortalite ve morbiditeye neden olan ilerleyici hava akımı kısıtlaması ile karakterize alevlenmelerle seyreden bir hastalıktır. Bu çalışmanın amacı KOAH alevlenme tanısı ile hastaneye yatışı yapılan, fizyoterapist tarafından serviste takibe alınan hastaların çeşitli klinik özelliklerinin ve atak belirteçlerinin incelenmesidir.
Yöntem: Retrospektif olarak planlanan çalışmaya 91 hasta dahil edildi. Hastaların sosyodemografik ve klinik özellikleri, Modifiye Medikal Araştırma Kurulu Dispne Skalası (mMRC), KOAH Değerlendirme Testi (CAT) ve KOAH Birleşik Değerlendirme Skoru (GOLD) değerleri fizyoterapi kayıt dosyalarından alındı.
Bulgular: Çalışmaya dahil edilen 91 hastanın 73’ü erkek (%80.2), 18’i (%19.8) kadındı. Hastaların yaş ortalaması 72.49±10.10 yıldı. Hastaların sigara tüketimi ortalama 46.34±39.00 paket/yıldı. GOLD’a göre 34’ü B grup hasta, 57’si ise D grup hastaydı. CAT skoru ortalaması 23.05±8.22 ve mMRC skoru ortalaması 2.93±1.01 olarak hesaplandı. Grup B ve D hastalarına ait CAT ve mMRC skorları incelendiğinde iki grup arasında istatistiksel olarak anlamlı fark saptandı (p<0.05). KOAH alevlenme tanısı ile yatan hastaların yaşları ve hastalık süreleri arasındaki ilişki Pearson korelasyon analizi ile incelendiğinde istatistiksel olarak anlamlı bir ilişki görülmedi (p>0.05). Hastaların CAT ve mMRC skorları arasındaki ilişki incelendiğinde istatistiksel olarak anlamlı pozitif yönlü orta düzeyde korelasyon saptandı (p<0.05, r=0.669).
Sonuç: Sosyodemografik, fiziksel ve klinik özellikler KOAH atak profilini etkileyen faktörler arasında yer alsa da; hastalık süresi ve evresi, CAT ve mMRC skoru ve uzun süreli oksijen tedavisinin atak profilini oluşturan temel bileşenler olduğu görülmüştür. Atak geçiren hastalarda yakın izlem ile semptom kontrolünün sağlanmasında multidisipliner yaklaşımın gerektiğini düşünmekteyiz.
References
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- 14. Yorgancıoğlu A, Polatlı M, Aydemir Ö, et al. Reliability and validity of Turkish version of COPD assessment test. Tuberk Toraks. 2012;60(4):314-320.
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- 18. Gadoury MA, Schwartzman K, Rouleau M, et al. Self-management reduces both short-and long-term hospitalisation in COPD. Eur Respir J. 2005;26(5):853-857.
- 19. de Torres JP, Cote CG, López MV, et al. Sex differences in mortality in patients with COPD. Eur Respir J. 2009;33(3):528-535.
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- 29. Anthonisen NR, Skeans MA, Wise RA, et al. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142(4):233-239.
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- 31. Gunen H, Yilmaz M, Aktas O et al. Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study. Int J Chron Obstruct Pulmon Dis. 2015;10:2485-2494.
- 32. Hacıevliyagil SS, Günen H, Mutlu LC, et al. The causes of exacerbations in patients with chronic obstructive pulmonary disease. Res Diseases. 2006;17:8-12.
- 33. Gaude GS, Rajesh BP, Chaudhury A, et al. Outcomes associated with acute exacerbations of chronic obstructive pulmonary disorder requiring hospitalization. Lung India. 2015;32(5):465-472.
- 34. Patel IS, Seemungal TA, Wilks M, et al. Relationship between bacterial colonization and the frequency, character and severity of COPD exacerbations. Thorax. 2002;57:759-764.
- 35. Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med. 2006;173(10):1114-1121.
- 36. Kaltsakas G, Rovina N, Symiakakis M, et al. Relationship of mMRC and CAT scores in COPD patients. Europe Respir Soc. 2013;42(S):1-2.
- 37. Huang WC, Wu MF, Chen HC, et al. Features of COPD patients by comparing CAT with mMRC: a retrospective, cross-sectional study. NPJ Prim Care Respir Med. 2015;5(25):15063.
- 38. Halpin DM, Miravitlles M, Metzdorf N, et al. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017;12:2891-2908.
- 39. Vogelmeier CF, Alter P. Assessing symptom burden. Clin Chest Med. 2020;41(3):367-373.
THE ATTACK PROFILE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RETROSPECTIVE STUDY
Year 2021,
, 44 - 48, 31.08.2021
Özge İpek Dongaz
,
Dilara Özen Oruk
,
Asalet Aybüke Güp
,
Özge Oral Tapan
,
Banu Bayar
,
Kılıçhan Bayar
Abstract
Objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and exacerbations causing severe mortality and morbidity. The aim of this study is to examine the various clinical characteristics and attack markers of patients who were hospitalized with the diagnosis of COPD exacerbation and followed up in the ward by a physiotherapist.
Method: 91 patients were included in the study, which was planned retrospectively. Sociodemographic and clinical characteristics of the patients, Modified Medical Research Board Dyspnoea Scale (mMRC), COPD Assessment Test (CAT), and COPD Combined Assessment Score (GOLD) values were obtained from the physiotherapy registry files.
Results: 73 of total 91 patients were male (80.2%) and 18 (19.8%) were female. The mean age of the patients was 72.49±10.10 years. The mean smoking level of the patients was 46.34±39.00 cigarette packs/year. According to GOLD, 34 were group B patients and 57 were group D patients. The mean CAT score was 23.05±8.22 and the mean mMRC score was 2.93±1.01. When the CAT and mMRC scores of the patients in Group B and D were analyzed, a statistically significant difference was found between the two groups (p<0.05). When the relationship between the diagnosis of COPD exacerbation and hospitalized patients' ages and duration of illness was analyzed with Pearson correlation analysis, no statistically significant correlation was found (p>0.05). When the relationship between the CAT and mMRC scores of the patients was analyzed, a statistically significant positive moderate correlation was found (p<0.05, r=0.669).
Conclusion: Sociodemographic, physical, and clinical characteristics are the factors that affect the attack profile of COPD, but disease duration and stage, CAT and mMRC score, and long-term oxygen therapy were found to be the main components of attack profile. We think that multidisciplinary approach is required for symptom control with close follow-up in patients who have attack.
References
- 1. Vogelmeier CF, Criner GJ, Martinez FJ. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557-582.
- 2. Guarascio AJ, Ray SM, Finch CK. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clinicoecon Outcomes Res. 2013;5:235-245.
- 3. World Health Organisation. Noncommunicable disease: fact sheet: World Health Organisation; http://www.who.int/en/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). 2017.
- 4. Halbert RJ, Natoli JL, Gano A, et al. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006;28(3):523-532.
- 5. Singh D, Agusti A, Anzueto A, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5):1900164.
- 6. Kim J, Yoon HI, Oh YM, et al. Lung function decline rates according to GOLD group in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1819-1827.
- 7. Bhatt SP, Dransfield MT. Chronic obstructive pulmonary disease and cardiovascular disease. Transl Res. 2013;162(4):237-251.
- 8. Global strategy for prevention, diagnosis and management of COPD. 2020 Report. [AvailableFrom: Http://Goldcopd.Org/Gold-Reports/]
- 9. Effing T, Kerstjens H, van der Valk P, et al. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study. Thorax. 2009;64:956-962.
- 10. Huber MB, Wacker ME, Vogelmeier CF, et al. Comorbid influences on generic health-related quality of life in COPD: a systematic review. PLoS One. 2015;10:e0132670.
- 11. Fletcher C, Peto R. The Natural History Of Chronic Airflow Obstruction. BMJ. 1977;1:645-648.
- 12. Bestall JC, Paul EA, Garrod R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54:581-586.
- 13. Jones PW, Price D, van der Molen T. Role of clinical questionnaires in optimizing everyday care of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2011;6:289-296.
- 14. Yorgancıoğlu A, Polatlı M, Aydemir Ö, et al. Reliability and validity of Turkish version of COPD assessment test. Tuberk Toraks. 2012;60(4):314-320.
- 15. Global strategy for prevention, diagnosis and management of COPD. 2017 Report. [Available From: http://Goldcopd.Org/Gold-Reports/]
- 16. Ratner B. The correlation coefficient: Its values range between +1/−1, or do they?. J Target Meas Anal Mark. 2009;17:139-142.
- 17. Warren CP. The nature and causes of chronic obstructive pulmonary disease: a historical perspective. The Christie Lecture 2007, Chicago, USA. Can Respir J. 2009;16(1):13-20.
- 18. Gadoury MA, Schwartzman K, Rouleau M, et al. Self-management reduces both short-and long-term hospitalisation in COPD. Eur Respir J. 2005;26(5):853-857.
- 19. de Torres JP, Cote CG, López MV, et al. Sex differences in mortality in patients with COPD. Eur Respir J. 2009;33(3):528-535.
- 20. Çakmak A, Tunçbilek A. Incidence of chronic obstructive lung disease in the employee of the ankara set cement factory. Tuberk Toraks. 1998;46:345-351.
- 21. Shah T, Churpek MM, Coca Perraillon M, et al. Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion. Chest. 2015;147:1219-1226.
- 22. Soler-Cataluña JJ, Martínez-García MÁ, Román Sánchez P, et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005;60:925-931.
- 23. Patil SP, Krishnan JA, Lechtzin N, et al. In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease. Arch Intern Med. 2003;163:1180-1186.
- 24. Niewoehner DE, Lokhnygina Y, Rice K, et al. Risk indexes for exacerbations and hospitalizations due to COPD. Chest. 2007;131:20-28.
- 25. Pouw EM, Ten Velde GP, Croonen BH, Kester AD, Schols AM, Wouters EF. Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss. Clin Nutr. 2000;19(2):95-99.
- 26. Lainscak M, von Haehling S, Doehner W, et al. Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. J Cachexia Sarcopenia Muscle. 2011;2:81-86.
- 27. Kim MH, Lee K, Kim KU, et al. Risk factors associated with frequent hospital readmissions for exacerbation of COPD. Tuberc Respir Dis. 2010;69:243-249.
- 28. Cingözler Ö, Özge C, Tamer L, et al. The relation of weight loss with hyperinflation, serum adiponectin, ghrelin and leptin levels in chronic obstructive pulmonary disease. Eurasian J Pulmonol. 2014;16(1):21-26.
- 29. Anthonisen NR, Skeans MA, Wise RA, et al. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142(4):233-239.
- 30. Halpin DM, Miravitlles M, Metzdorf N, et al. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017;12:2891-2908.
- 31. Gunen H, Yilmaz M, Aktas O et al. Categorization of COPD patients in Turkey via GOLD 2013 strategy document: ALPHABET study. Int J Chron Obstruct Pulmon Dis. 2015;10:2485-2494.
- 32. Hacıevliyagil SS, Günen H, Mutlu LC, et al. The causes of exacerbations in patients with chronic obstructive pulmonary disease. Res Diseases. 2006;17:8-12.
- 33. Gaude GS, Rajesh BP, Chaudhury A, et al. Outcomes associated with acute exacerbations of chronic obstructive pulmonary disorder requiring hospitalization. Lung India. 2015;32(5):465-472.
- 34. Patel IS, Seemungal TA, Wilks M, et al. Relationship between bacterial colonization and the frequency, character and severity of COPD exacerbations. Thorax. 2002;57:759-764.
- 35. Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med. 2006;173(10):1114-1121.
- 36. Kaltsakas G, Rovina N, Symiakakis M, et al. Relationship of mMRC and CAT scores in COPD patients. Europe Respir Soc. 2013;42(S):1-2.
- 37. Huang WC, Wu MF, Chen HC, et al. Features of COPD patients by comparing CAT with mMRC: a retrospective, cross-sectional study. NPJ Prim Care Respir Med. 2015;5(25):15063.
- 38. Halpin DM, Miravitlles M, Metzdorf N, et al. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017;12:2891-2908.
- 39. Vogelmeier CF, Alter P. Assessing symptom burden. Clin Chest Med. 2020;41(3):367-373.