2012 June - The Clinical Severity, Co-morbidities and Management Pattern of Chronic Obstructive Pulmonary Disease Patients in an Acute Regional Hospital Print
Dr Lik-Hang AU; Department of Medicine and Geriatrics, Tai Po Hospital
Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common respiratory diseases worldwide. Previous studies had shown the under-prescription of long acting bronchodilators in Hong Kong. Limited local studies had focused on in-patient characteristics, treatment pattern and admission frequency.
Objective: To assess the disease spectrum, severity, admission numbers, co-morbidities and management pattern of in-hospital COPD patients in an acute regional hospital.
Method: COPD patients admitted to the Alice Ho Miu Ling Nethersole Hospital (AHNH) during January 2010 to December 2010 were recruited. Demographic data, exacerbations frequency and spirometry data were assessed. The usage of acute or long term non-invasive ventilation (NIV), long term oxygen therapy (LTOT), and prescription of medications based on spirometry values available were also recorded.
Result: 253 patients were included in the study with mean age 78.4. The mean number of admissions due to COPD exacerbation was 1.96 and 54.2% had one admission in 2010. Two-third (64%, n=162) had at least one spirometry done in or before 2010. Mean forced expiratory volume in one second was 1.02 liters (SD +/- 0.425 liters) and the FEV1 (% predicted) was 54.9%. 10.5% (n=17) belonged to Global Initiative for Chronic Obstructive Lung Disease stage 1, 42% (n=68) belonged to stage 2, 37% (n=60) belonged to stage 3 and 10.5% (n=17) belonged to stage 4. Short acting bronchodilators and oral theophylline were commonly use. Long acting bronchodilators like long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA) were being prescribed in 16.6% (n=42) and 6.7% (n=17), respectively.
Conclusion: Most of our patients were old with majority belonging to moderate and severe COPD groups. Significant proportion had at least 2 or more admissions in 2010. The adherence to latest treatment guidelines seemed inadequate with low prescription rate of long acting bronchodilators.
