Kronik obstrüktif akciğer hastalığında komorbidite durumu
Küçük Resim Yok
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Cumhuriyet Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Günümüzde kronik obstruktif akciğer hastalığı (KOAH) ile doğrudan ilişkisi olup olmamasına bakılmaksızın KOAH'a eşlik eden pek çok komorbid hastalık tanımlanmaktadır. KOAH'da komorbiditelerin görülme oranı fazladır ve bu hastalıkların prognoz üzerine önemli etkileri olabilir. KOAH'da en sık görülen komorbiditeler, iskelet kas anormallikleri, hipertansiyon, diabet, koroner arter hastalığı, kalp yetmezliği, kanser, pulmoner vasküler hastalıklar ve serebrovasküler hastalıklardır. Bu çalışmanın amacı KOAH'da ensık rastlanan komorbid hastalıkları tespit ederek, bu hastalıklar hakkında farkındalık sağlamak, tanı ve tedavilerini yaparak KOAH'ın kötüye gidişini önlemektir. Bu çalışma 30.09.2014-28.02.2015 tarihleri arasında Cumhuriyet Üniversitesi Göğüs Hastalıkları Anabilim Dalı Polikliniğine başvuran Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014'e göre KOAH tanısı almış 179 hasta alınarak yapıldı. Komorbiditeler Charlson komorbidite indeksine göre değerlendirildi. Hastaların komorbidite tanıları yüz yüze görüşme yöntemi ve hastaların dosyaları retrospektif olarak incelenerek saptanmıştır. Hastaların arteryel kan gazı (AKG), C-reaktf protein (CRP), hemoglobin (HGB), Hemotokrit (Hct) ve ortalama eristrosit hacmi (MCV) değerleri dosyaları retrospektif olarak incelenerk kayıt altına alınmıştır. Çalışmaya alınan olguların yaşları 29 ile 85 yıl arasında değişmekteydi. (ortalaması 64.51±11.04) idi. Hastaların %64.8'inde enaz bir komorbidite vardı. Olgularda ensık görülen komorbiditeler (%60.9) hipertansiyon (HT), (%27.4) diyabetes mellitus (DM), (%33) koroner arter hastalığı (KAH), (%20.1) konjestif kalp yetmezliği (KKY), (%8.4) serebrovasküler hastalık (SVH), (%19.6) depresyon, (%13.4) anemi, (%11.2) peptik ülser, (%15.6) gastroözefajiyal reflü (GÖR), (%3.4) akciğer kanseri, (%15.6) osteoporoz, (%8.9) obstrüktif uyku apne sendromu (OUAS), (%4.5) kronik böbrek yetmezliği (KBY), (%9.5) periferik damar hastalığı (PDH) ve (%4.5) pulmoner hipertansiyon (PHT) idi. Yapılan değişik çalışmalarda komorbidite prevelansları, incelenen hasta grubunun sayı ve niteliklerine, incelenen komorbiditelere, komorbidite belirleme yöntemlerine ve komorbid hastalıkların ülke ve/veya bölgesindeki perevelans farklılıklarına bağlı olarak değişkenlik göstermektedir. Çalışmamızda ensık rastalanan komorbiditelerin HT, KAH ve DM olduğu saptandı. Bu Türkiye'de yapılan diğer çalışmalarla uyumluydu. Sonuç olarak, KOAH olgularında sık hastane başvurusu ve yatışlarının azaltılabilmesi, KOAH'ın erken tanısı, etkin tedavisi, beslenme desteğinin yanısıra komorbid hastalıkların multidisipliner anlayışla kontrol altına alınması bağlıdır. Böylece KOAH'ın komorbid hastalıklar nedeniyle kötüye gidiş önleneceği gibi hastaların bu nedenle hastanede kalış süreleride azaltılabilinir. Anahtar kelimeler: KOAH, komorbidite, KOAH ve sistemik etkiler, KOAH ve koroner arter hastalığı, KOAH ve konjestif kalp yetmezliği.
Up to now, various conditions comorbid to Chronic Obstructive Pulmonary Disease (COPD) have been demonstrated regardless of whether they are directly related to COPD or not. Comorbidities are common in COPD and they may have important effects on prognosis. The mostfrequent comorbidities in COPD including; musculoskletal abnormalities, hypertension, diabetes, heart failure, cancers and coronary artery, pulmonary vascular and cerebrovascular diseases. The aim of this study is to detect the most common comorbidities in COPD. Thus, it may be possible that provide making an early diagnosis for COPD, as well as prevent the comorbidity-dependent worsening of COPD, and an awareness will be able to created in corresponding disciplines. Our study has been conducted on 179 patients diagnosed with COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014, who have admitted to Outpatient Clinic of Pulmonology Department of the Cumhuriyet University from 30.09.2014to 28.01.2015. Comorbidities were analyzed depending on Charlson Comorbidity İndex. Comorbidities of patients were recorded through direct conversation with them and researching their folder retrospectively. Certain parameters of patients were recorded such as arterial blood gas (ABG), C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct) and mild cellular volume (MCV) through analyzing of their folders retrospectively. Mean age was 64.51±11.04 (ranged between 29 and 85), and 64,8% of patients had at least one comorbidity. The most common comorbidities included hypertension (HT; 60,9%), diabetes (DM; 27,4%), coronary artery disease (CAD; 33%), congestive heart failure (CHF; 20, 1%), cerebrovascular disease (CVD; 8,4%), depression (19,6%), anemia (13,4%), peptic ulcer (11,2%), gastroesophageal reflux (GER; 15,6%), lung cancer (3,4%), osteoporosis (15,6%), obstructive sleep apnea hypopnea syndrome (8,9%), chronic renal failure (4,5%), peripheral vessel disease (PVD; 9,5%) and pulmonary hypertension (PHT: 4.5%). Comorbidity prevalence rates reported by various studies were very heterogeneous depending on nature and number of the patient group, studied comorbidities, comorbidity identification techniques, and on prevalence variations in the countries and/or areas in which comorbidities were studied. Most frequent comorbidities were hypertension, coronary artery disease and diabetes mellitus on our study. That was correlated with other studies performed in Turkey. As a result, reducing of the frequent admissions and hospitalization cases in COPD depends on early diagnosis and effective treatment of COPD and nutritional support as well as on keeping the comorbidities under control with multidisciplinary understanding. Thus, worsening of COPD due to comorbidities may be prevented, as well as hospitalization durationfor those with COPD may be reduced. Key words: COPD, Comorbidity, COPD and systemic effects, COPD and Coronary Artery Disease, COPD and Congestive Heart Failure
Up to now, various conditions comorbid to Chronic Obstructive Pulmonary Disease (COPD) have been demonstrated regardless of whether they are directly related to COPD or not. Comorbidities are common in COPD and they may have important effects on prognosis. The mostfrequent comorbidities in COPD including; musculoskletal abnormalities, hypertension, diabetes, heart failure, cancers and coronary artery, pulmonary vascular and cerebrovascular diseases. The aim of this study is to detect the most common comorbidities in COPD. Thus, it may be possible that provide making an early diagnosis for COPD, as well as prevent the comorbidity-dependent worsening of COPD, and an awareness will be able to created in corresponding disciplines. Our study has been conducted on 179 patients diagnosed with COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014, who have admitted to Outpatient Clinic of Pulmonology Department of the Cumhuriyet University from 30.09.2014to 28.01.2015. Comorbidities were analyzed depending on Charlson Comorbidity İndex. Comorbidities of patients were recorded through direct conversation with them and researching their folder retrospectively. Certain parameters of patients were recorded such as arterial blood gas (ABG), C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct) and mild cellular volume (MCV) through analyzing of their folders retrospectively. Mean age was 64.51±11.04 (ranged between 29 and 85), and 64,8% of patients had at least one comorbidity. The most common comorbidities included hypertension (HT; 60,9%), diabetes (DM; 27,4%), coronary artery disease (CAD; 33%), congestive heart failure (CHF; 20, 1%), cerebrovascular disease (CVD; 8,4%), depression (19,6%), anemia (13,4%), peptic ulcer (11,2%), gastroesophageal reflux (GER; 15,6%), lung cancer (3,4%), osteoporosis (15,6%), obstructive sleep apnea hypopnea syndrome (8,9%), chronic renal failure (4,5%), peripheral vessel disease (PVD; 9,5%) and pulmonary hypertension (PHT: 4.5%). Comorbidity prevalence rates reported by various studies were very heterogeneous depending on nature and number of the patient group, studied comorbidities, comorbidity identification techniques, and on prevalence variations in the countries and/or areas in which comorbidities were studied. Most frequent comorbidities were hypertension, coronary artery disease and diabetes mellitus on our study. That was correlated with other studies performed in Turkey. As a result, reducing of the frequent admissions and hospitalization cases in COPD depends on early diagnosis and effective treatment of COPD and nutritional support as well as on keeping the comorbidities under control with multidisciplinary understanding. Thus, worsening of COPD due to comorbidities may be prevented, as well as hospitalization durationfor those with COPD may be reduced. Key words: COPD, Comorbidity, COPD and systemic effects, COPD and Coronary Artery Disease, COPD and Congestive Heart Failure
Açıklama
Tıp Fakültesi, Aile Hekimliği Ana Bilim Dalı
Anahtar Kelimeler
Aile Hekimliği, Family Medicine
