Comparison of tobacco induced versus biomass induced chronic obstructive pulmonary disease patients during acute exacerbations.

Abstract

Objective: To investigate the differences in clinical characteristics and in-hospital outcomes between BM-COPD and T-COPD during exacerbation. Study Design: Prospectively study. Setting: Jinnah Post Graduate Medical Center, Karachi. Period: January to December 2018. Material & Methods: One hundred and fifty seven consecutive patients with acute exacerbation of COPD were study. They were categorized into two groups taking into account the exposure to tobacco smoke or biomass. Clinical features and outcomes were evaluated into both groups. Data was entered in SPSS version 21. Results: Total 151 participants were recruited into the study with 100 (66.2%) participants in smoking group and 51(33.8%) participants biomass exposure group. Overall median age of patients was 65 (IQR=56 – 70) years. Age was not significantly different among two exposure group (p=0.506). Proportion of females were significantly higher in Biomass group (p<0.001). None of the biomarker was significantly different at the time of presentation among two groups. History of ischemic heart disease was more prevalent in biomass exposure than smoking group (p=0.016). Initial response to BiPAP was better in tobacco induced group at 24 hours because improvement in PaCo2 and heart rate was seen (p0.014) but overall mortality and morbidity was same. Among biomass exposure there were 8 (16.3%) mortalities while mortalities in smoking group were 15 (15.3%) and statistically the difference was not significant (p=0.026). Conclusion: Biomass-induced COPD is more prevalent in female patients, with comorbid in the form of Ischemic Heart Disease. The present study demonstrated that patients with BM-COPD and T-COPD during their acute exacerbation have similar mortality. Therefore clinicians should start the same standard treatment in any patient with BM-COPD patient during exacerbation as validated in T-COPD.