Current Clinical Profile of Respiratory Diseases in Geriatric Population

Arulkumaran, P (2012) Current Clinical Profile of Respiratory Diseases in Geriatric Population. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : With increasing life expectancy geriatric population (people aged 65 and above) contribute to significant percentage of the World population. India is in a phase of demographic transition. As per the 2001 census, the population of the elderly in India was 49 million as compared with 20 million in 1951. It has been projected that by the year 2050, the number of elderly people would rise to about 324 million. Current life expectancy is 62.3 years for males and 65.3 years for females. They also contribute to significant percentage of respiratory diseases. Aging has been shown to be associated with gradual decline in many aspects of pulmonary functions, waning of immunity and the immunological mechanisms show a declining efficiency as the antibodies form much less rapidly in old age than in younger adulthood. This study is to find the current spectrum of respiratory diseases in geriatric population in a tertiary care centre. AIM : To study the current profile of Respiratory diseases in Geriatric Population attending a tertiary care centre MATERIALS AND METHODS : STUDY DESIGN : This is Prospective (Observational) study designed to find the current profile of respiratory diseases in Geriatric population. STUDY CENTER : Institute of Thoracic Medicine, Chetpet and Department of Thoracic Medicine, Government Rajiv Gandhi General Hospital, Madras Medical College, Chennai-3. STUDY DURATION : February 2011 to October 2011. INCLUSION CRITERIA : Consenting patients with age 65 years or more with Respiratory Symptoms. EXCLUSION CRITERIA : 1. Patients with age less than 65. 2. Patients not giving consent. STUDY PROCEDURE : Geriatric patients, those consenting, with respiratory complaints attending Institute of Thoracic Medicine, chetpet and Department of Thoracic Medicine, Rajiv Gandhi Government General Hospital, Chennai, were taken up for study. In this study 1234 patients were studied in which males were 773 and females were 461. 394 patient required inpatient care. 890 patients belong to the age group 65-74years and 344 in 75+years age group. R outine investigations such as chest skiagram, sputum NT C/S, sputum gram stain, sputum AFB and spirometry were done. Those patient requiring inpatient care were admitted in the Thoracic Medicine ward, Rajiv Gandhi Government General Hospital. Apart from above mentioned investigation they were subjected to further investigation, as per need, such a Renal function test, Liver function test, blood culture, ECG, ECHO, CT CHEST, Bronchoscopy, thoracocentesis, pleural biopsy and CT guided biopsy. RESULTS : In this study 1234 patients were studied in which males were 773 and females were 461. 394 patient required inpatient care. 890 patients belong to the age group 65-74years and 344 in 75+years age group. CONCLUSION : Respiratory Infections and their complications, consisting of Upper Respiratory Tract Infection, Acute Bronchitis, Community Acquired Pneumonia, Pulmonary Tuberculosis and Its Sequelae, constitute the major respiratory morbidity among Geriatric population attending this tertiary care center. Upper Respiratory Tract Infection and Acute Bronchitis is the commonest cause for seeking outpatient care. Pulmonary tuberculosis is the second commonest respiratory infection and ranks fifth in overall respiratory morbidity. Sequelae of pulmonary tuberculosis causes significant respiratory morbidity in the elderly constituting about 10.3%. Pulmonary tuberculosis and its sequelae together constitute 18.96%. Among infective disease community acquired pneumonia ranks third. Diabetes is the commonest co morbidity associated with community acquired pneumonia. COPD is the second most common respiratory morbidity without any gender difference.Active smoking is the commonest predisposing factor for COPD in males whereas it is exposure to indoor pollution in females.AECOPD is the most common cause of inpatient care. Bronchial asthma constitutes 9.48% of the morbidity. Carcinoma lung constitutes 7.77%. Squamous cell carcinoma is the commonest type of lung cancer among males and it is adenocarcinoma in females.Active smoking is the commonest risk factor for lung cancer in males whereas it is exposure to indoor pollution in females. Lung cancer patients in this age group presented in an advanced stage. Idiopathic pulmonary fibrosis is the commonest diffuse pulmonary lung disease in this age group followed by hypersensitivity pneumonitis. Silicosis was the only pneumoconiosis found in this study. Among pleural diseases infective causes like tuberculous effusion and parapneumonic effusion was the commonest followed by malignant pleural effusion and pneumothorax.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Current Clinical Profile ; Respiratory Diseases ; Geriatric Population.
Subjects: MEDICAL > Tuberculosis and Respiratory Medicine
Depositing User: Subramani R
Date Deposited: 28 Feb 2018 17:16
Last Modified: 28 Feb 2018 17:16

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