Clinical Factors Predictive of COPD Diagnosis in a Community Hospital

Sukanya Tongdee; Sittichai Khamsai; Kittisak Sawanyawisuth

doi:10.3889/oamjms.2022.7931

Authors

Sukanya Tongdee Department of Medicine, Chumpae Hospital, Khon Kaen, Thailand
Sittichai Khamsai Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Kittisak Sawanyawisuth Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

DOI:

https://doi.org/10.3889/oamjms.2022.7931

Keywords:

Body mass index, Chest X-ray, Diagnosis

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an irreversible obstructive airway disease. Diagnosis can be made using a spirometry which may not be available in resource-limited setting or developing countries.

AIM: This study aimed to evaluate if clinical factors can be predictive of COPD diagnosis.

MATERIALS AND METHODS: This study was a retrospective cohort study conducted at community hospital. The inclusion criteria were adult patients who had clinical symptoms suggestive of COPD and had performed adequate pulmonary function tests. Patients were categorized into two groups by diagnosis of COPD. Clinical predictors of being COPD were executed by multivariate logistic regression analysis.

RESULTS: There were 200 patients who met the study criteria. Of those, 136 patients (68.00%) had compatible pulmonary function test with COPD. There were eight factors in the final predictive model for being COPD (Table 1). Among these factors, three factors were independently associated with being COPD: Productive sputum, body mass index, and hyperinflation by chest X-ray. The hyperinflation by chest X-ray had highest adjusted odds ratio of 10.93 (95% CI 3.23, 36.96).

CONCLUSIONS: Productive sputum, body mass index, and hyperinflation by chest X-ray were independent factors for COPD diagnosis. Physicians in resource-limited setting may use these clinical factors as diagnostic tool for COPD.

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References

Biener AI, Decker SL, Rohde F. Prevalence and treatment of chronic obstructive pulmonary disease (COPD) in the United States. JAMA. 2019;322(7):602. https://doi.org/10.1001/jama.2019.10241 PMid:31429884 DOI: https://doi.org/10.1001/jama.2019.10241

Khamsai S, Chootrakool A, Limpawattana P, Chindaprasirt J, Sukeepaisarnjaroen W, Chotmongkol V, et al. Hypertensive crisis in patients with obstructive sleep apnea-induced hypertension. BMC Cardiovasc Disord. 2021;21(1):310. https://doi.org/10.1186/s12872-021-02119-x PMid:34162333 DOI: https://doi.org/10.1186/s12872-021-02119-x

Khamsai S, Mahawarakorn P, Limpawattana P, Chindaprasirt J, Sukeepaisarnjaroen W, Silaruks S, et al. Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea. Multidiscip Respir Med. 2021;16(1):777. https://doi.org/10.4081/mrm.2021.777 PMid:34650797 DOI: https://doi.org/10.4081/mrm.2021.777

Sanlung T, Sawanyawisuth K, Silaruks S, Chattakul P, Limpawattana P, Chindaprasirt J, et al. Clinical characteristics and complications of obstructive sleep apnea in srinagarind hospital. J Med Assoc Thai. 2020;103:36-9.

Soontornrungsun B, Khamsai S, Sawunyavisuth B, Limpawattana P, Chindaprasirt J, Senthong V, et al. Obstructive sleep apnea in patients with diabetes less than 40 years of age. Diabetes Metab Syndr. 2020;14(6):1859-63. https://doi.org/10.1016/j.dsx.2020.09.008 PMid:32992217 DOI: https://doi.org/10.1016/j.dsx.2020.09.008

Khamsai S, Kachenchart S, Sawunyavisuth B, Limpawattana P, Chindaprasirt J, Senthong V, et al. Prevalence and risk factors of obstructive sleep apnea in hypertensive emergency. J Emerg Trauma Shock. 2021;14(2):104-7. https://doi.org/10.4103/JETS.JETS_47_20 PMid:34321809 DOI: https://doi.org/10.4103/JETS.JETS_47_20

Chen XR, Leung SH, Li YC. Chronic obstructive pulmonary disease (COPD) management in the community: How could primary care team contribute? BMC Fam Pract. 2020;21:184. https://doi.org/10.1186/s12875-020-01256-0 PMid:32900370 DOI: https://doi.org/10.1186/s12875-020-01256-0

Denguezli M, Daldoul H, Harrabi I, Chouikha F, Ghali H, Burney P, et al. Prevalence and characteristics of undiagnosed COPD in adults 40 years and older-reports from the tunisian population-based burden of obstructive lung disease study. COPD. 2020;17:515-22. https://doi.org/10.1080/15412555.2020.1804848 PMid:32781855 DOI: https://doi.org/10.1080/15412555.2020.1804848

Buist AS, Vollmer WM, Sullivan SD, Weiss KB, Lee TA, Menezes AM, et al. The burden of obstructive lung disease initiative (BOLD): Rationale and design. COPD. 2005;2:277-83. PMid:17136954 DOI: https://doi.org/10.1081/COPD-57610

Gupta N, Malhotra N, Ish P. GOLD 2021 guidelines for COPD-what’s new and why. Adv Respir Med. 2021;89:344-6. https://doi.org/10.5603/ARM.a2021.0015 PMid:33881161 DOI: https://doi.org/10.5603/ARM.a2021.0015

Kornmann O, Beeh KM, Beier J, Geis UP, Ksoll M, Buhl R, et al. Newly diagnosed chronic obstructive pulmonary disease. Clinical features and distribution of the novel stages of the global initiative for obstructive lung disease. Respiration. 2003;70:67-75. https://doi.org/10.1159/000068417 PMid:12584394 DOI: https://doi.org/10.1159/000068417

Stephens MB, Yew KS. Diagnosis of chronic obstructive pulmonary disease. Am Fam Physician. 2008;78:87-92.

Owens RL, Malhotra A. Sleep-disordered breathing and COPD: The overlap syndrome. Respir Care. 2010;55(10):1333-44. PMid:20875160

Adler D, Bailly S, Benmerad M, Joyeux-Faure M, Jullian-Desayes I, Soccal PM, et al. Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. PLoS One. 2020;15:e0235331. https://doi.org/10.1371/journal.pone.0235331 PMid:32645005 DOI: https://doi.org/10.1371/journal.pone.0235331

Chirakalwasan N, Teerapraipruk B, Simon R, Hirunwiwatkul P, Jaimchariyatam N, Desudchit T, et al. Comparison of polysomnographic and clinical presentations and predictors for cardiovascular-related diseases between non-obese and obese obstructive sleep apnea among Asians. J Clin Sleep Med. 2013;9:553-7. https://doi.org/10.5664/jcsm.2748 PMid:23772188 DOI: https://doi.org/10.5664/jcsm.2748

Joo HS, Wong J, Naik VN, Savoldelli GL. The value of screening preoperative chest x-rays: A systematic review. Can J Anaesth. 2005;52:568-74. https://doi.org/10.1007/BF03015764 PMid:15983140 DOI: https://doi.org/10.1007/BF03015764

Washko GR. Diagnostic imaging in COPD. Semin Respir Crit Care Med. 2010;31(3):276-85. https://doi.org/10.1055/s-0030-1254068 Mid:20496297 DOI: https://doi.org/10.1055/s-0030-1254068

Pudney E, Doherty M. Plain chest X-ray (CXR) in the diagnosis of chronic obstructive pulmonary disease (COPD). Eur Respir J. 2016;48:PA3936. https://doi.org/10.1183/13993003.congress-2016.PA3936 DOI: https://doi.org/10.1183/13993003.congress-2016.PA3936

Sawunyavisuth B. What are predictors for a continuous positive airway pressure machine purchasing in obstructive sleep apnea patients? Asia Pac J Sci Technol. 2018;23(3):APST-23-03-10. https://doi.org/10.14456/apst.2018.10

Chaiear N, Nirarach K, Kawamatawong T, Krisorn P, Burge PS. Proportion of workers having work-related asthma symptoms in a cassava factory, Nakhon Ratchasima province, Thailand. Asia Pac J Sci Technol. 2020;25(2):APST-25-02-08.

Hlaing SS, Puntumetakul R, Wanpen S, Saiklang P. Updates on core stabilization exercise and strengthening exercise: A review article. Asia Pac J Sci Technol 2021;26(4):APST-26-04-12. https://doi.org/10.14456/apst.2021.42

Sawunyavisuth B, Ngamjarus C, Sawanyawisuth K. Any effective intervention to improve CPAP adherence in children with obstructive sleep apnea: A systematic review. Global Pediatric Health. 2021;8:84. https://doi.org/10.1177/2333794X211019884 PMid:34104700 DOI: https://doi.org/10.1177/2333794X211019884

Jeerasuwannakul B, Sawunyavisuth B, Khamsai S, Sawanyawisuth K. Prevalence and risk factors of proteinuria in patients with type 2 diabetes mellitus. Asia Pac J Sci Technol. 2021;26(4):APST-26-04-02. https://doi.org/10.14456/apst.2021.32

Manasirisuk P, Chainirun N, Tiamkao S, Lertsinudom S, Phunikhom K, Sawunyavisuth B, et al. Efficacy of generic atorvastatin in a real-world setting. Clin Pharmacol. 2021;13:45-51. https://doi.org/10.2147/CPAA.S285750 PMid:33707972 DOI: https://doi.org/10.2147/CPAA.S285750

Sawunyavisuth B. What personal experiences of CPAP use affect CPAP adherence and duration of CPAP use in OSA patients? J Med Assoc Thai. 2018;101:S245-9.