Clinical Profile and Risk Factors in COPD Patients: A Tertiary Care-Based Observational Study from Western India
DOI:
https://doi.org/10.55489/njmr.150420251153Keywords:
Smoking, Occupational Exposure, Dyspnoea, COPD, Hospitalization, GujaratAbstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is a major global health concern, marked by persistent airflow limitation and high morbidity. Understanding its clinical and risk profiles is crucial for effective management, especially in high-burden areas like India.
Methods: A cross-sectional study was conducted at C.U. Shah Medical College, Gujarat, from November 2022 to February 2023, enrolling 100 spirometry-confirmed COPD patients (post-bronchodilator FEV₁/FVC <0.70). Data on demographics, symptoms, smoking, occupation, lab parameters, imaging, and clinical outcomes were analyzed using chi-square, t-tests, and correlation analysis.
Results: The cohort included 60% males with a mean age of 66 years. Dyspnoea (90%), cough (85%), and sputum production (70%) were the most common symptoms. Smoking was significantly associated with advanced COPD (p <0.001). Industrial and agricultural workers had higher rates of bronchiectasis and bronchovascular markings (p <0.005). Hematocrit showed an inverse correlation with oxygen saturation (p <0.004). Severe dyspnoea was linked to increased hospitalizations (p <0.004).
Conclusion: Smoking and occupational exposure are key contributors to COPD severity. Dyspnoea severity predicts hospitalization rates. Focused public health interventions are essential to mitigate disease burden and improve outcomes.
References
Cunha AS, Raposo B, Dias F, Henriques S, Martinho H, Pedro AR. Management of Chronic Obstructive Pulmonary Disease: Constraints in Patient Pathway and Mitigation Strategies. Port J Public Health. 2024 Jan 12;42(2):93-100. DOI: https://doi.org/10.1159/000535474 PMid:39070594 PMCid:PMC11277348 DOI: https://doi.org/10.1159/000535474
López-Campos JL, Tan W, Soriano JB. Global burden of COPD. Respirology. 2016;21(1):14-23. DOI: https://doi.org/10.1111/resp.12660 PMid:26494423 DOI: https://doi.org/10.1111/resp.12660
Verma A, Gudi N, Yadav UN, Roy MP, Mahmood A, Nagaraja R, Nayak P. Prevalence of COPD among population above 30 years in India: a systematic review and meta-analysis. J Glob Health. 2021;11:04038. DOI: https://doi.org/10.7189/jogh.11.04038 PMid:34484706 PMCid:PMC8397327 DOI: https://doi.org/10.7189/jogh.11.04038
Mannino DM, Roberts MH, Mapel DW, Zhang Q, Lunacsek O, Grabich S, van Stiphout J, Meadors BL, Feigler N, Pollack MF. National and Local Direct Medical Cost Burden of COPD in the United States From 2016 to 2019 and Projections Through 2029. Chest. 2024 May;165(5):1093-1106. DOI: https://doi.org/10.1016/j.chest.2023.11.040 PMid:38042365 DOI: https://doi.org/10.1016/j.chest.2023.11.040
Nugent R. Chronic diseases in developing countries: health and economic burdens. Ann N Y Acad Sci. 2008;1136:70-79. DOI: https://doi.org/10.1196/annals.1425.027 PMid:18579877 DOI: https://doi.org/10.1196/annals.1425.027
Garcia-Aymerich J, Farrero E, Félez MA, Izquierdo J, Marrades RM, Antó JM; Estudi del Factors de Risc d'Agudització de la MPOC investigators. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003 Feb;58(2):100-105. DOI: https://doi.org/10.1136/thorax.58.2.100 PMid:12554887 PMCid:PMC1746561 DOI: https://doi.org/10.1136/thorax.58.2.100
Buttery SC, Zysman M, Vikjord SAA, Hopkinson NS, Jenkins C, Vanfleteren LEGW. Contemporary perspectives in COPD: Patient burden, the role of gender and trajectories of multimorbidity. Respirology. 2021 May;26(5):419-441. DOI: https://doi.org/10.1111/resp.14032 PMID: 33751727 PMCID: PMC9011688 DOI: https://doi.org/10.1111/resp.14032
Jones PW, Agusti AG. Outcomes and markers in the assessment of chronic obstructive pulmonary disease. Eur Respir J. 2006;27(4):822-832. DOI: https://doi.org/10.1183/09031936.06.00145104 PMid:16585091 DOI: https://doi.org/10.1183/09031936.06.00145104
Washko GR. Diagnostic imaging in COPD. Semin Respir Crit Care Med. 2010;31(3):276-285. DOI: https://doi.org/10.1055/s-0030-1254068 PMid:20496297 PMCid:PMC4334134 DOI: https://doi.org/10.1055/s-0030-1254068
Lynch DA, Austin JH, Hogg JC, Grenier PA, Kauczor HU, Bankier AA, et al. CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 2015;277(1):192-205. DOI: https://doi.org/10.1148/radiol.2015141579 PMid:25961632 PMCid:PMC4613878 DOI: https://doi.org/10.1148/radiol.2015141579
Murgia N, Gambelunghe A. Occupational COPD the most under-recognized occupational lung disease? Respirology. 2022;27(6):399-410. DOI: https://doi.org/10.1111/resp.14272 PMid:35513770 PMCid:PMC9321745 DOI: https://doi.org/10.1111/resp.14272
Fromer L. Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes. Int J Chron Obstruct Pulmon Dis. 2011;6:605-614. DOI: https://doi.org/10.2147/COPD.S24692 PMid:22162647 PMCid:PMC3232168 DOI: https://doi.org/10.2147/COPD.S24692
Yang IA, Jenkins CR, Salvi SS. Chronic obstructive pulmonary disease in never-smokers: risk factors, pathogenesis, and implications for prevention and treatment. Lancet Respir Med. 2022;10(5):497-511. DOI: https://doi.org/10.1016/S2213-2600(21)00506-3 PMid:35427530 DOI: https://doi.org/10.1016/S2213-2600(21)00506-3
Sasaki KI, Fukumoto Y. Sarcopenia as a comorbidity of cardiovascular disease. J Cardiol. 2022;79(5):596-604. DOI: https://doi.org/10.1016/j.jjcc.2021.10.013 PMid:34906433 DOI: https://doi.org/10.1016/j.jjcc.2021.10.013
Lindenauer PK, Stefan MS, Pekow PS, Mazor KM, Priya A, Spitzer KA, et al. Association between initiation of pulmonary rehabilitation after hospitalization for COPD and 1-year survival among Medicare beneficiaries. JAMA. 2020;323(18):1813-1823. DOI: https://doi.org/10.1001/jama.2020.4437 PMid:32396181 PMCid:PMC7218499 DOI: https://doi.org/10.1001/jama.2020.4437
Agustí A, Celli BR, Criner GJ, Halpin DMG, Anzueto A, Barnes P, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 report: GOLD executive summary. Am J Respir Crit Care Med. 2023;207(7):819-837. DOI: https://doi.org/10.1164/rccm.202301-0106PP PMid:36856433 PMCid:PMC10111975 DOI: https://doi.org/10.1164/rccm.202301-0106PP
Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med. 2019;200(8):e70-88. DOI: https://doi.org/10.1164/rccm.201908-1590ST PMid:31613151 PMCid:PMC6794117 DOI: https://doi.org/10.1164/rccm.201908-1590ST
Adeloye D, Chua S, Lee C, Basquill C, Papana A, Theodoratou E, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health. 2015;5(2):020415. DOI: https://doi.org/10.7189/jogh.05.020415 PMid:26755942 PMCid:PMC4693508 DOI: https://doi.org/10.7189/jogh.05.020415
Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Int J Tuberc Lung Dis. 2012;16(9):1270-1277. DOI: https://doi.org/10.5588/ijtld.12.0005 PMid:22871327 DOI: https://doi.org/10.5588/ijtld.12.0005
Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet. 2009;374(9691):733-743. DOI: https://doi.org/10.1016/S0140-6736(09)61303-9 PMid:19716966 DOI: https://doi.org/10.1016/S0140-6736(09)61303-9
Rushton L. Chronic obstructive pulmonary disease and occupational exposure to silica. Rev Environ Health. 2007;22(4):255-272. DOI: https://doi.org/10.1515/REVEH.2007.22.4.255 PMid:18351226 DOI: https://doi.org/10.1515/REVEH.2007.22.4.255
Gershon AS, Dolmage TE, Stephenson A, Jackson B. Chronic obstructive pulmonary disease and socioeconomic status: a systematic review. COPD. 2012;9(3):216-226. DOI: https://doi.org/10.3109/15412555.2011.648030 PMid:22497534 DOI: https://doi.org/10.3109/15412555.2011.648030
Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5):1900164. DOI: https://doi.org/10.1183/13993003.00164-2019 PMid:30846476 DOI: https://doi.org/10.1183/13993003.00164-2019
Regan EA, Lynch DA, Curran-Everett D, Curtis JL, Austin JH, Grenier PA, et al. Clinical and radiologic disease in smokers with normal spirometry. JAMA Intern Med. 2015;175(9):1539-1549. DOI: https://doi.org/10.1001/jamainternmed.2015.2735 PMid:26098755 PMCid:PMC4564354 DOI: https://doi.org/10.1001/jamainternmed.2015.2735
Kohansal R, Martinez-Camblor P, Agustí A, Buist AS, Mannino DM, Soriano JB. The natural history of chronic airflow obstruction revisited: an analysis of the Framingham offspring cohort. Am J Respir Crit Care Med. 2009;180(1):3-10. DOI: https://doi.org/10.1164/rccm.200901-0047OC PMid:19342411 DOI: https://doi.org/10.1164/rccm.200901-0047OC
Sood A, Petersen H, Blanchette CM, Meek P, Belinsky SA. Wood smoke exposure and gene promoter methylation are associated with increased risk for COPD in smokers. Am J Respir Crit Care Med. 2010;182(9):1098-1104. DOI: https://doi.org/10.1164/rccm.201002-0222OC PMid:20595226 PMCid:PMC3001253 DOI: https://doi.org/10.1164/rccm.201002-0222OC
Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350(10):1005-1012. DOI: https://doi.org/10.1056/NEJMoa021322 PMid:14999112 DOI: https://doi.org/10.1056/NEJMoa021322
Vestbo J, Edwards LD, Scanlon PD, Yates JC, Agusti A, Bakke P, et al. Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med. 2011;365(13):1184-1192. DOI: https://doi.org/10.1056/NEJMoa1105482 PMid:21991892 DOI: https://doi.org/10.1056/NEJMoa1105482
Toy EL, Gallagher KF, Stanley EL, Swensen AR, Duh MS. The economic impact of exacerbations of chronic obstructive pulmonary disease and exacerbation definition: a review. COPD. 2010;7(3):214-228. DOI: https://doi.org/10.3109/15412555.2010.481697 PMid:20486821 DOI: https://doi.org/10.3109/15412555.2010.481697
Godtfredsen NS, Lam TH, Hansel TT, Leon ME, Gray N, Dresler C, et al. COPD-related morbidity and mortality after smoking cessation: status of the evidence. Eur Respir J. 2008;32(4):844-853. DOI: https://doi.org/10.1183/09031936.00160007 PMid:18827152 DOI: https://doi.org/10.1183/09031936.00160007
Kurmi OP, Semple S, Simkhada P, Smith WC, Ayres JG. COPD and chronic bronchitis risk of indoor air pollution from solid fuel: a systematic review and meta-analysis. Thorax. 2010;65(3):221-228. DOI: https://doi.org/10.1136/thx.2009.124644 PMid:20335290 DOI: https://doi.org/10.1136/thx.2009.124644
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