Journal of Datta Meghe Institute of Medical Sciences University

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 15  |  Issue : 3  |  Page : 341--346

A study of clinical, radiological, and spirometric profile of COPD


Sameer Adwani, Babaji Ghewade, Mohit Gupte, Ulhas Jadhav 
 Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India

Correspondence Address:
Dr. Babaji Ghewade
Department of Respiratory Medicine, JNMC, Sawangi Meghe - 442 001, Wardha, Maharashtra
India

Abstract

Background: Chronic obstructive lung disease (COPD) is a high prevalence chronic disease and disease that leads to substantial health costs. The diagnosis of COPD is based on respiratory symptoms, persistent airflow obstruction and presence of causative agent such as the inhalation of multiple pollutants, primarily tobacco. Although the COPD is usually underdiagnosed, inaccurate diagnosis is also not uncommon. Material and Methods: A thorough knowledge of clinical, radiological and spirometric data is important for the proper diagnosis and management of COPD. The ususal symptoms of cough, breathlessness and chest tightness may be present in many other diseases. Results: A correlation of symptoms, spirometry and radiology is more likely to give us a more accurate diagnosis and help in management of patients. The usual symptoms of COPD with radiological findings suggestive of COPD and a spirometry showing obstructive abnormality make the diagnosis more accurate. Conclusion: In addition this may also help to diagnose any complications and comorbidities of COPD which can be missed if suspicion is low and patient is not evaluated.



How to cite this article:
Adwani S, Ghewade B, Gupte M, Jadhav U. A study of clinical, radiological, and spirometric profile of COPD.J Datta Meghe Inst Med Sci Univ 2020;15:341-346


How to cite this URL:
Adwani S, Ghewade B, Gupte M, Jadhav U. A study of clinical, radiological, and spirometric profile of COPD. J Datta Meghe Inst Med Sci Univ [serial online] 2020 [cited 2021 Apr 20 ];15:341-346
Available from: http://www.journaldmims.com/text.asp?2020/15/3/341/308570


Full Text



 Introduction



Chronic obstructive pulmonary disease (COPD) is a high prevalence chronic disease and disease that leads to substantial health costs.[1],[2],[3] The diagnosis of COPD is based on respiratory symptoms, persistent airflow obstruction, and the presence of causative agent such as the inhalation of multiple pollutants, primarily tobacco.[1],[2] Although the COPD is usually underdiagnosed, inaccurate diagnosis is also not uncommon.[4],[5]

A thorough knowledge of clinical, radiological, and spirometric data is important for the proper diagnosis and management of COPD. The unsual symptoms of cough, breathlessness, and chest tightness may be present in many other diseases. A correlation of symptoms, spirometry, and radiology is more likely to give us a more accurate diagnosis and help in the management of patients. The usual symptoms of COPD with radiological findings suggestive of COPD and a spirometry showing obstructive abnormality make the diagnosis more accurate. In addition, this may also help to diagnose any complications and comorbidities of COPD, which can be missed if a suspicion is low, and the patient is not evaluated.

Aim and objectives

The aim of this study is to study the clinical, radiological, and spirometric profile of COPD at the Acharya Vinoba Bhave Rural Hospital.

 Materials and Methods



This hospital-based observational study was conducted on 350 COPD patients in the Department of Respiratory Medicine of Datta Meghe Institution of Medical Sciences, Wardha, Maharashtra, India, from August 2016 to December 2018. Patients were enrolled after matching inclusion and exclusion criteria. Diagnosed COPD patients were admitted. Other causes of acute breathlessness such as pulmonary thromboembolism, pneumothorax, pneumonia, pleural effusion, cardiac failure, patients having tuberculosis, and those who are newly diagnosed COPD patients were excluded from the study. The Institutional Ethics Committee permission was obtained.

Detailed history along with the general and respiratory system examination was done, and the findings were recorded in a predesigned pro forma. All investigations done by the patient in the past and present were noted.

Ethical clearance

The Institutional Ethics Committee of DMIMSDU has approved the Research work proposed to be carried out at Jawaharlal Nehru Medical College, Sawangi(M), Wardha. Date: 22nd Feb 2016 with Reference no DMIMS(DU)/IEC/2016/168.

 Results



Most of the study population belongs to the age group of more than 60 years (68.3%), whereas the remaining were between 45 and 60 years (31.7%) [Table 1] and [Chart 1].{Table 1}[INLINE:1]

There was male predominance (67.1%) among the study population as compared to females (32.9%) [Table 2] and [Chart 2].{Table 2}[INLINE:2]

Most of the study population were underweight (52%) followed by normal weight (36.3%), overweight (8.9%), and obese (2.8%) [Table 3] and [Chart 3].{Table 3}[INLINE:3]

Among the study population, 54.9% had COPD from more than 5 years, and 45.1% had for <5 years [Table 4] and [Chart 4].{Table 4}[INLINE:4]

A history of smoking was observed in 49% [Table 5] and [Chart 5] of the study population, and most of the study population had smoking index of 30–39 packs (35%) followed by 20–29 packs (31%), 10–19 packs (14%), and more than 40 packs (14%).{Table 5}[INLINE:5]

History of biomass exposure was observed in 36.9% of the study population [Table 6] and [Chart 6].{Table 6}[INLINE:6]

Breathlessness (98%) was the most common presenting complaints among the study population followed by cough (80%), expectoration (69%), chest pain (32%), loss of weight and appetite (29%), and fever (23%) [Table 7] and [Chart 7].{Table 7}[INLINE:7]

Rhonchi (71%) was the most common respiratory findings among study population followed by decreased breath sound (39%), crepitation (69%), and bronchial breathing (21%) [Table 8] and [Chart 8].{Table 8}[INLINE:8]

On chest X-ray and high-resolution computerized tomography (HRCT) thorax, normal, emphysema, consolidation, bronchiectasis, cavity, pleural effusion, and mass were observed in 32%, 56%, 11.7%, 10%, 19.4%, 2.9%, and 8.9%, respectively [Table 9] and [Chart 9].{Table 9}[INLINE:9]

Most of the study population were MMRC dyspnea of Grade III (40%) followed by Grade IV (24.9%), Grade II (23.4%), and Grade I (9.7%) [Table 10] and [Chart 10].{Table 10}[INLINE:10]

Most of the study population had Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage C (38%) followed by GOLD Stage B (37%), GOLD Stage D (13%), and GOLD Stage A (12%) [Table 11] and [Chart 11].[2],[6],[7]{Table 11}[INLINE:11]

 Discussion



Most of the study population belongs to the age group of more than 60 years (68.3%), whereas remaining were between 45 and 60 years (31.7%). There was male predominance (67.1%) among study population as compared to females (32.9%). Guleria et al. have reported similar findings in their study where the maximum number of patients had the age of onset between 40 and 70 years.[1],[4],[5] This findings is in agreement with the study by Narayanagowda et al., in which of 107 patients, the most common age group was 55–65 years (40.19%). The next common age group was 65–75 years (32.71%).[1],[4],[6] This is because it was more commonly seen in patients with advanced lung disease as an expression of deterioration in host defenses at the bronchial mucosal level.[2],[6]

This findings correlate well with the study conducted by Niranjan Mambally Rachaiah et al., in which males accounted for 88%, with a male-female ratio of 6.33:1.[1],[4],[8] In the present study, all males were smokers, six females patients were nonsmokers, but all of them were exposed to smoke of burnt fuels which is very common in the rural Indian population. In this part of the country, cooking is predominantly by using wood and cow dung. This is possibly a strong risk factor for the development of COPD among female patients.[1],[4],[9] This findings is in agreement with the study by Narayanagowda et al., in which out of 107 patients, 72 were male patients.[1],[4],[6]

Most of the study population were underweight (52%) followed by normal weight (36.9%), overweight (8.9%), and obese (2.8%). In the study population, 55% had COPD from more than 5 years and 45% had for <5 years.

History of smoking was observed in 49% of the study population, and most of the study population had smoking index of 30–39 packs (35%) followed by 20–29 packs (31%), 10–19 packs (14%), and more than 40 packs (14%). History of biomass exposure was observed in 36.9% of the study population. Similarly, the study by Narayanagowda et al., in which out of 72, 45 (62.5%) were smokers and 27 (37.5%) were nonsmokers.[1],[4],[6]

Breathlessness (98%) was the most common presenting complaint among study population followed by cough (80%), expectoration (44.9%), fever (23.7%), chest pain (22.3%), loss of weight and appetite (19.1%), and hemoptysis (2.57%). Most of the study population were MMRC dyspnea of Grade III (40%) followed by Grade IV (24.9%), Grade II (23.4%), Grade I (9.7%), and Grade 0 (2%). Similarly, in the study conducted by Sunil Babu et al., 100% of the patients presented with breathlessness and cough.[1],[5] Many had peripheral edema and distension of the abdomen. Padmavathi et al. reported dyspnea in 100%, pedal edema in 90.4%, and cyanosis in 83.2% of group.[1],[5]

Rhonchi (71%) was the most common respiratory findings amongst study population followed by decreased breath sound (39%), crepitation (69%), and bronchial breathing (21%).

On chest X-ray and HRCT thorax, normal, emphysema, consolidation, bronchiectasis, cavity, pleural effusion and mass was observed in 32%, 56%, 11.7%, 10%, 19.4%, 2.9%, and 8.9% respectively.

Most of the study population had GOLD Stage C (38%) followed by GOLD Stage B (37%), GOLD Stage D (13%), and GOLD Stage A (12%). This findings is in agreement with the study conducted by Ladeira et al., in which GOLD Stage B (50%) followed by GOLD Stage C (28%).[1],[4]

There was a significant decrease in spirometry parameters such as forced-expiratory volume in 1 s (FEV1), forced-vital capacity (FVC), and FEV1/FVC as the GOLD staging increases.[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25],[26],[27],[28]

 Conclusion



This article shows the clinical, radiological, and sprometric profile of COPD patients. Breathlessness and cough are the most common presenting features of COPD and rhonchii being the most common clinical finding. Emphysema is the most common radiologic finding of COPD patients. A good correlation leads to a better diagnosis of COPD and helps in effective management of the patient.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest

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