Chronic obstructive pulmonary disease at Chulalongkorn Hospital: an analysis of 400 episodes

Four hundred episodes of COPD among patients admitted to Chulalongkorn Hospital between 1982 and 1986 were analyzed. There were 193 males and 45 females with 325 and 75 episodes of admission, respectively; the average age on admission was 68.4 +/- 0.5 years. The most significant associated underlying factor was cigarette smoking in 94 per cent of the cases, with the patients smoking an average of 1.15 packs of cigarettes per day for 43 years. In our study, 26.8 per cent of the patients had a cough, with the average age at onset being 47.4 +/- 2.1 years. The most common clinical manifestation was dyspnea with 58.5, 35.2 and 0.5 per cent having dyspnea functional class II, III, IV and with the average age at onset being 61.1 +/- 0.7, 66.6 +/- 0.7 and 71.0 +/- 1.0 years, respectively. An important manifestation on admission was dyspnea functional class III and IV, which were present in of 89 per cent of the cases. The main precipitating factors which led to the patients' admission were upper respiratory tract infection, pneumonia, bronchospasms and congestive heart failure, which accounted for 48.0, 10.0, 8.5, 31.8 and 18.3 per cent of the cases, respectively. With regard to these complications, there were 16.5, 48.3, 31.1 and 12.5 per cent of the patients who suffered respiratory failure requiring assisted ventilation, corpulmonale, polycythemia and peptic ulcer, respectively. Arterial blood gas on admission revealed a pH level of 7.36 +/- 0.1, pCO2 of 53.3 +/- 23.7 torr, and PO2 of 54.2 +/- 19.9 torr.(ABSTRACT TRUNCATED AT 250 WORDS)