COPD
CLINICAL EVALUATION AND DIRECT COST ANALYSIS OF COPD EXACERBATION IN PATIENTS OF TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.29309/TPMJ/2018.25.06.269Keywords:
Exacerbation, MMRC Dyspnea Scale Score, Bode Index, Dose Index Score and Direct Medical CostAbstract
Introduction: Chronic obstructive pulmonary disease (COPD) is considered as
a major public health concern to the medical community. COPD is associated with episodic
exacerbations which are evident as enhanced dyspnea, worsening of lung function, cough
and production of sputum. Objectives: To assess 126 COPD exacerbated patients in a tertiary
care hospital of Karachi, Pakistan. Study Design: Descriptive study. Setting: Various wards
of tertiary care Ziauddin Hospitals. Period: November 2016 to April 2017. Methods: Patients
were classified into Type I, II and III exacerbation. Consent was taken from patients’ caregivers,
while hospital permission was also obtained. At the time of study all the patients were receiving
appropriate therapy and patients were clinically in stable condition. Data collection was
performed by thorough reviewing and recording the data from patients’ medical records. Also,
the questionnaire was filled by the principal investigator to collect three evaluation parameters
including MMRC Dyspnea Scale Score, Bode Index and Dose Index Scoring System. Data
was expressed in terms of percentages.Direct medical costs were also determined in Rupees
(Rs.) of these patients. Results: Results indicated that most of the male patients were found
to have exacerbation. It was found that patients having smoking habits were found to have
higher frequency of COPD exacerbation (Type I, 11 (8.730 %); Type II, 36 (28.571 %); Type
III, 40 (31.746 %)) as compared to non smokers. Major complaints which were found in 126
patients were shortness of breath, fever, cough and increased sputum. It was found that most
common comorbid diseases found in 126 patients were hypertension, diabetes mellitus and
tuberculosis. In this study, the direct cost analysis of 126 COPD exacerbated patients were also
carried out. Conclusion: Present study indicated multiple indicators for repeated exacerbations
in COPD. Which in terns increase the treatment costs for the patients.
