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Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease.

Gothi D, Gupta SS, Kumar N, Sood K - Lung India (2015 Nov-Dec)

Bottom Line: Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%.AECOPD have a high prevalence of OSAS.Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, ESI-Post Graduate Institute of Medical Sciences and Research, Delhi, India.

ABSTRACT

Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known.

Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome.

Materials and methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome.

Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m(2) and 31.82 ± 5.80 kg/m(2) (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001).

Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

No MeSH data available.


Related in: MedlinePlus

Comparison of cases in two groups according to oxygen saturation findingsGroup I = Only COPD, Group II = Overlap
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Figure 2: Comparison of cases in two groups according to oxygen saturation findingsGroup I = Only COPD, Group II = Overlap

Mentions: Among patients hospitalized for AECOPD, a total of 51 patients who satisfied the inclusion criteria were enrolled and evaluated for the presence of overlap syndrome. Out of a total of 51 patients, 38 (74.5%) did not have OSAS i.e., they had only COPD, while 13 (25.5%) had COPD with OSAS i.e., overlap syndrome. Table 1 and Chart 1 show the comparison of severity of exacerbation between only COPD and overlap. The majority of only COPD cases had mild and moderate exacerbations whereas majority of cases in overlap had severe, very severe and life-threatening exacerbations. Statistically, the difference between two groups was significant (P = 0.021). Also, with the increasing severity of exacerbation, the mean apnea hypopnea index (AHI) increased [Chart 2, Table 2]. The average saturation on admission and during polysomnography was also significantly worse in overlap group compared to only COPD group [Table 2].


Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease.

Gothi D, Gupta SS, Kumar N, Sood K - Lung India (2015 Nov-Dec)

Comparison of cases in two groups according to oxygen saturation findingsGroup I = Only COPD, Group II = Overlap
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663860&req=5

Figure 2: Comparison of cases in two groups according to oxygen saturation findingsGroup I = Only COPD, Group II = Overlap
Mentions: Among patients hospitalized for AECOPD, a total of 51 patients who satisfied the inclusion criteria were enrolled and evaluated for the presence of overlap syndrome. Out of a total of 51 patients, 38 (74.5%) did not have OSAS i.e., they had only COPD, while 13 (25.5%) had COPD with OSAS i.e., overlap syndrome. Table 1 and Chart 1 show the comparison of severity of exacerbation between only COPD and overlap. The majority of only COPD cases had mild and moderate exacerbations whereas majority of cases in overlap had severe, very severe and life-threatening exacerbations. Statistically, the difference between two groups was significant (P = 0.021). Also, with the increasing severity of exacerbation, the mean apnea hypopnea index (AHI) increased [Chart 2, Table 2]. The average saturation on admission and during polysomnography was also significantly worse in overlap group compared to only COPD group [Table 2].

Bottom Line: Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%.AECOPD have a high prevalence of OSAS.Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, ESI-Post Graduate Institute of Medical Sciences and Research, Delhi, India.

ABSTRACT

Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known.

Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome.

Materials and methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome.

Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m(2) and 31.82 ± 5.80 kg/m(2) (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001).

Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

No MeSH data available.


Related in: MedlinePlus