A study of prevalence and associated factors of COPD exacerbation among COPD patients in Sanamchaikhet hospital, Chachoengsao Province, Thailand
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Abstract
Background: Exacerbation of COPD is a significant condition that has several undesirable impacts on health aspects and socioeconomic aspects. There has been lacking study of COPD exacerbation in Thailand so far, particularly in rural areas. This study aimed to determine the prevalence and associated factors of COPD exacerbation.
Methods: This was a cross-sectional study conducted on COPD patients (diagnosed according to Global Initiative for Chronic Obstructive Lung Disease diagnostic criteria) at Sanamchaikhet hospital, Chachoengsao province, Thailand from 1st September 2017 to 1st September 2018. The relevant variables (sex, age, body mass index, occupation exposure to dust/fume/gas, smoking status, passive smoking, severity of airflow limitation, respiratory infections, comorbidity, COPD medication, inhalation techniques, influenza vaccination, compliance, and follow-up) were collected and statistically analyzed.
Result: There were 150 COPD patients included in this study. The majority were males (79%), the mean age was 66.29±9.42 years old. The prevalence of COPD exacerbation was 47.3% with the highest frequency of exacerbation in January as 30 times (14.29%). Multivariable analysis revealed that pneumonia (OR 10.52, 95% CI 1.78-62.08, P=0.009), using triple therapy (LABA and ICS plus LAAC) (OR 7.74, 95% CI 2.45-24.46, P<0.001), poor compliance (OR 3.33, 95% CI 1.24-8.92, P=0.017), good inhalation techniques (OR 0.182, 95% CI 0.06-0.51, P=0.001) and loss of follow up (OR 42.055, 95% CI 9.18-192.55, P<0.001) were independently associated with COPD exacerbation.
Conclusion: The prevalence of COPD exacerbation was comparatively high in Thailand. Five associated factors were identified. Inhalation techniques, poor compliance, and loss of follow-up should be modified as well as pneumonia that should be prevented. Regarding the use of triple therapy (LABA and ICS plus LAAC), further research should be performed to determine this associated factor.
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