DefinePK

Research Objective

To investigate the differences in clinical characteristics and in-hospital outcomes between biomass-induced COPD (BM-COPD) and tobacco-induced COPD (T-COPD) during acute exacerbations.

Methodology

A prospective observational study was conducted at Jinnah Post Graduate Medical Center, Karachi, from January to December 2018. One hundred and fifty-seven consecutive patients with acute exacerbation of COPD were recruited and categorized into two groups based on exposure to tobacco smoke or biomass. Clinical features and outcomes were evaluated. Data was analyzed using SPSS version 21.

Methodology Flowchart

                        graph TD
    A[Recruit Patients with AECOPD] --> B[Categorize by Exposure: Tobacco vs. Biomass];
    B --> C[Evaluate Clinical Features and Outcomes];
    C --> D[Data Entry into SPSS v21];
    D --> E[Statistical Analysis];
    E --> F[Compare Characteristics and Outcomes];
    F --> G[Draw Conclusions];                    

Discussion

The study suggests that while biomass-induced COPD is more prevalent in females and associated with a higher incidence of ischemic heart disease, the in-hospital outcomes and mortality during acute exacerbations are comparable to tobacco-induced COPD. This implies that standard treatment protocols for acute exacerbations of COPD are likely equally effective for both types of induced COPD. The study acknowledges limitations such as being a single-centered study and potential recall bias in biomass exposure assessment.

Key Findings

- A total of 151 participants were recruited, with 100 (66.2%) in the smoking group and 51 (33.8%) in the biomass exposure group.
- The proportion of females was significantly higher in the biomass group (p<0.001).
- History of ischemic heart disease was more prevalent in the biomass exposure group (p=0.016).
- Initial response to BiPAP was better in the tobacco-induced group at 24 hours, with improvements in PaCO2 and heart rate (p=0.014).
- Overall mortality and morbidity were similar between the two groups. Mortality was 16.3% in the biomass group and 15.3% in the smoking group, with no statistically significant difference (p=0.026).

Conclusion

Biomass-induced COPD is more prevalent in female patients and is associated with ischemic heart disease. During acute exacerbations, patients with BM-COPD and T-COPD exhibit similar mortality. Clinicians should apply the same standard treatment for BM-COPD patients during exacerbations as validated for T-COPD.

Fact Check

- Study Period: January to December 2018. (Confirmed in text)
- Total Participants Recruited: 151. (Confirmed in text)
- Mortality in Biomass Group: 8 (16.3%). (Confirmed in text)

Mind Map