ABSTRACT
To assess the health-related quality of life [HRQL] of patients with chronic obstructive pulmonary disease [COPD] in 4 Gulf Council Cooperation countries. We conducted a cross-sectional survey between December 2011 and March 2012 in the following countries: Kingdom of Saudi Arabia [Riyadh, Dammam, and Jeddah], Kuwait, Bahrain, and the United Arab Emirates. The HRQL was measured using the COPD Assessment Test [CAT] and the Chronic Respiratory Disease Questionnaire-Self-Administered Standardized questionnaire [CRQ-SAS]. We recruited 120 patients from 6 centers in 4 countries. Their average forced expiratory volume [FEV][1] was 49.3% [+/- 13.4] of predicted, and the ratio of FEV[1] to forced vital capacity was 0.58 [+/- 0.11]. The average COPD Assessment Test [CAT] score was 20.4 +/- 7.6; CAT scores were highest for Riyadh [24.1 +/- 7.7]; and lowest for Kuwait [18.5 +/- 9.2], with no significant difference between the centers. For the CRQ-SAS, the dyspnea domain score was 4.6 +/- 1.6, the fatigue domain score was 4.3 +/- 1.3, the emotional domain was 4.6 +/- 1.2, and the mastery domain was 4.8 +/- 1.4. The correlation coefficients of the association between the CAT score and the 4 domains of the CRQ-SAS for all of the centers combined was statistically significant. The CAT and CRQ-SAS revealed that the patients with COPD experienced a moderate to severe impact from the disease, and a considerably compromised quality of life in the GCC countries
ABSTRACT
Non-invasive positive pressure ventilation [NPPV] is a relatively new modality of managing acute respiratory failure [ARF]. It has not been applied before in our area. The aim of this study is to verify the use of NPPV on patients with ARF at a general hospital level. All patients admitted at the Al-Amiri Hospital, Kuwait [a secondary medical center] between 1999 and 2001 with ARF and met the inclusion criteria were included in the study. The non-invasive mode of nasal ventilation was used as the respiratory support. A total of 21 patients were included in the final analysis. The major cause of ARF type 2 was chronic obstructive pulmonary disease [COPD] in 71%. The overall success rate of NPPV trials was 71.4%. In the successful trials of ARF type 2, the arterial blood gas parameters of PaCo2 [p<0.005], pH [p=0.023], and PaO2 [p<0.001] showed improvement from the first hour of intervention. Analysis of variance with repeated measurement for the arterial blood gas variables showed statistical significance of changes in favor of NPPV during initial close monitoring with p<0.001. The percentage of successful trials at the general wards was 82% versus 67% for the intensive care unit cases [ICU]. Surprisingly, failure of trials related mainly to the clinical status of the patients. Non-invasive positive pressure ventilation is an effective ventilatory support in ARF in a proper clinical setting. It may be used safely in the general hospital outside the ICU