FREQUENCY AND PREDICTORS OF COPD AND RESTRICTIVE LUNG DISEASE IN PRIMARY CARE

Abstract

ABSTRACT Background: To determine the frequency and risk factors of COPD and Restrictive Lung Diseases in a Primary Care Center in Karachi. Methods: All patients coming to Primary Health Care Center presenting with cough were enrolled in the study. They were seen by Consultant Family Physician who filled the questionnaires after informed consent. Chest was examined and the patients underwent PEF. If PEF was <70% then office based spirometry test was done. Those who did not achieve reversibility in FEV1 after bronchodilation were labeled COPDers. Data was analyzed using SPSS 20. Mean and standard deviation were taken out for numerical data. Categorical data was shown in frequency and percentage. Chi-square was taken out to see association of risk factors with the outcome. P-value <0.05 was considered significant. Results: In our study, 54 (35.7%) participants had obstructive lung pathology. Prevalence of COPD came out to be 6.62% whereas7 subjects (4.7%) had restrictive lung disease. COPD was seen more in females as compared to males (84.6% vs 15.4% p-value<0.00). Also smoking had statistically significant association with COPD (42.5% p-value <0.00). All those who had COPD, smoked more than 11 years. Manifestation of the disease with cough (63.3%) and wheeze (33.9%)came out to be statistically significant .Past history of exacerbation of restrictive lung disease(1.3%, p-value 0.054) and MRC dyspnea score of stage 2 (25%, p-value 0.001) revealed statistically significant association with restrictive pathology. Conclusion: The prevalence of COPD and restrictive lung diseases are soaring at an alarming rate owing to smoking and industrial pollution. It’s important to give smoking cessation advice to patients in primary care. A multidisciplinary approach with close cooperation of primary care physician, pulmonologist and cardiologist is imperative to put a halt to these ailments and thus reduce morbidity and mortality. Keywords: COPD, Bronchodilation, Spirometry, Restrictive Lung Disease, MRC, Dyspnea score.