Vidhya, T M (2023) Assessing the Severity, Systemic Involvement and Predicting the Future Exacerbations in COPD Patients using Bode Index: A Surrogate Marker. Masters thesis, Karpaga Vinayaga Institute of Medical Sciences, Madhuranthagam.
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Abstract
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the common, treatable and preventable lung diseases which is prevalent worldwide. COPD is characterised by tissue loss and a growing restriction of airflow, determined by spirometry. It is a state in which the respiratory symptoms are persistent and irreversible. ● According to the National Heart, Lung and Blood institute, COPD most commonly occurs in people more than 40 years of age who smoke or done smoking earlier in life or with other risk factors. COPD in young people is possible but it is rare. ● COPD patients present with respiratory symptoms predominantly, in addition when the disease gets advanced , patients do exhibit extra pulmonary manifestations such as cardio-vascular diseases (cor pulmonale), muscle as well as sexual dysfunction, osteoporosis, weight loss etc. ● Due to chronic inflammation brought on by extended exposure to biomass fuels, noxious particles or gases, most often cigarette smoke, it is linked to structural abnormalities in the lungs. The most frequent cause of COPD globally is cigarette smoking. Genetic factors do play a role in leading to COPD. ● COPD is considered to be the third leading cause of death worldwide.(Cardio-vascular disease related death ranks first and Cerebro-vascular accident related death ranks second). Around 250 million individuals are affected with COPD globally. ● COPD is an umbrella term which includes the following 3 conditions namely----- 1. EMPHYSEMA: Characterised by destruction of lung alveoli with air space enlargement. 2. CHRONIC BRONCHITIS: Condition with chronic cough and phlegm. 3. SMALL AIRWAY DISEASE: Condition in which small bronchioles are narrowed and reduced in number. Emphysema patients are otherwise called as Pink puffers. Chronic Bronchitis patients are otherwise known as Blue Bloaters. The common symptoms of COPD include chronic wheezing, persistent chesty coughs with phlegm, frequent chest infections, and worsening dyspnea. The objectives of a COPD evaluation for a doctor are to ascertain the decompensation risk, the severity of the illness, and the degree of airway restriction. When these criteria are precisely noted, determining how to direct therapy is much simpler. MATERIALS AND METHODS: A cross sectional study was conducted in male patients above 40 years of age who are chronic smokers >20 pack years, diagnosed as COPD visiting General Medicine And Pulmonary Medicine OPD at Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhuranthakam for the time duration of Jan 2021 to Oct 2022. The data was collected and entered into Microsoft excel data sheet and analysed using SPSS 22 version software. RESULT: The average age of the study population was 58.56 ± 8.08 years. Nearly 35% of the participants had shown changes with respect to the ECG findings. Among the study participants, 35% of them had presented with radiological changes. Nearly 33% of them had severe form of Pulmonary hypertension and 31% of them had severe COPD. The mean BMI was 21.42 ± 3.9. 69 patients who were moderately affected with COPD had BODE score less than 5 whereas 31 patients who had severely affected with COPD had BODE score greater than 5. CONCLUSION: BODE score in simple terms, is a helpful indicator to forecast the prognosis of COPD patients. Usually, COPD severity is assessed based on a single parameter- FEV1 (Forced Expiratory Volume in One second), but systemic manifestations are not reflected by FEV1. Hence, BODE INDEX with multi-dimensional quality involving 4 factors – BMI, airflow Obstruction, Dyspnoea and Exercise tolerance determines not only severity of the disease but also predicts hospitalisation, risk of death , assesses systemic involvement and future exacerbations. The variables were graded 0 to 3 (0 to 1 for BMI) and summed up to give a total score between 0 to 10, Higher scores indicating a greater risk of death. This study gave valuable insight for additional related studies and long-term management of COPD.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No: 200120504504 |
| Uncontrolled Keywords: | Severity, Systemic Involvement, Predicting, Future Exacerbations, COPD Patients, Bode Index, Surrogate Marker. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 29 Sep 2021 13:37 |
| Last Modified: | 28 Apr 2024 03:48 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/18158 |
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