KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA ATAK PROFİLİ: RETROSPEKTİF ÇALIŞMA

Öz

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.

Anahtar Kelimeler

• Kronik obstrüktif akciğer hastalığı
• Hospitalizasyon
• Tedavi
• Rehabilitasyon

THE ATTACK PROFILE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RETROSPECTIVE STUDY

Öz

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. 

Anahtar Kelimeler

• Chronic obstructive pulmonary disease
• Hospitalization
• Treatment
• Rehabilitation

Kaynakça

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