PREVALENCE OF RISK FACTORS AND DOCTOR-DIAGNOSED COMORBIDITIES IN PATIENTS WITH SPIROMETRICALLY CONFIRMED CHONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS

copd

Abstract

Background: Apart from the single spirometric study that has been done by Koul et al scant data exist regarding the various risk factors and comorbidities in patients with COPD in Kashmir which is a high burden state. The current study was aimed to evaluate the spirometric progression of chronic airflow limitation in participants of the BOLD 1 study (Burden of Obstructive Lung disease) as well as evaluate the development of doctor-diagnosed comorbidities in the follow-up period of about 10 years since the first evaluation of these participants.

  Objectives:

• To determine the prevalence of risk factors and doctor-diagnosed comorbidities among patients with spirometrically diagnosed COPD.
• To correlate the comorbidities with pulmonary functions and to determine the cause of death from contactable BOLD1 participants from records of death or verbal autopsies.
• Participants: Individuals > 40 years of age who had participated in BOLD 1.

Study design: A cohort study conducted on individuals who participated in BOLD 1.

Methods: Using BOLD survey methods (Tablets mediated collection of data) we administered BOLD questionnaires to the selected individuals. Spirometry was performed in all the subjects after completing the spirometry questionnaire.

Results: The total number of participants in the studied population were 124 among which males were 77 (62.09%) and females were 47{37.09%) with a male: female ratio of 1.63. COPD was more prevalent in the higher age groups with the prevalence of 41.2% in the age group 40-59 and 52.9% in the age group 60-79. The prevalence of COPD in females was 41.1% and 40.3% in males. Smoking was found to be the main risk factor for COPD. Among the patients with COPD, 73.7% were former smokers, 72.9% were active smokers, 72.7% were ever smokers and 3.6% were never smokers. Besides smoking, lower socioeconomic status, illiteracy, farming were the main risk factors in COPD patients. 29 patients had developed comorbidities during the course of follow up and among them, hypertension was the most prevalent comorbidity (68.6%). Heart failure was seen in 19.6%, coronary artery disease in 13.7%, diabetes mellitus in 7.8%, depression in 3.9%, and stroke in 2%. There were 20 known deaths in our study population and pneumonia was a major cause of mortality followed by an acute exacerbation of COPD.

Conclusion: Over the prevalence of COPD is more in the higher age group, smokers, individuals with lower socioeconomic and education status. Hypertension is the most common comorbidity among COPD patients and pneumonia is the major cause of mortality among COPD patients.