Factors Associated with Exacerbations among Patients with Chronic Obstructive Pulmonary Diseases, who attend Central Chest Clinic Borella, Sri Lanka

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive chronic lung disease characterized by air flow limitation and destruction of lung parenchyma which is not fully reversible. Estimated global prevalence of COPD was 11.7% which is nearly similar to the Sri Lankan COPD prevalence of 10.5%. “COPD exacerbations” define as an acute worsening of respiratory symptoms of COPD patients. Exacerbations are the most common cause of hospital admissions and deaths among COPD patients. Objectives: To evaluate the factors associated with exacerbations among COPD patients who attend Central Chest Clinic Borella. Methodology: Descriptive cross-sectional study was conducted among randomly selected sample of 150 patients using pre-tested interviewer administered questionnaire. Data was analysed using descriptive statistics and chi square test. Results: Out of 150 COPD patients, 66.7% were males and most were 50-69 years of age. Majority (84%) of the participants were married and (66%) currently engaged in paid occupation. Seventy four percent (n=111) of the participants had experienced episodes of exacerbations and of them 109 patients received inward treatments. Presence of any other respiratory disease (p=0.019), poor compliance to medication (p=0.009), presence of paddy fields near the residence (p=0.04), use of biomass fuel for cooking (p=0.001) were associated with exacerbation of COPD. Sociodemographic factors such as age, gender, civil status, BMI, smoking, alcohol consumption, exposure to occupational hazards, burning waste, outdoor air pollution, co morbidities were not significantly associated with exacerbation of COPD. Conclusions: Majority of the COPD patients had experienced episodes of exacerbations and received the inward treatments. Other respiratory conditions, poor drug compliance, residence nearby paddy fields and use of biomass fuel at home were associated with the exacerbations.