Factors Associated with GOLD Staging and BODE Index in Patients with Chronic Obstructive Lung Disease in Elderly

ABSTRACT

Background:We aimed to assess the clinical profile of Chronic obstructive pulmonary disease (COPD) occurring in elderly patient according to GOLD criteria/BODE index and to study the association of COPD with various risk factors in an elderly patient. Methods: We designed a hospital based observational study, in which we included patients with COPD who are elderly and admitted at the Lokmanya Tilak Municipal Medical College and Hospital, Mumbai from January 2015 till July 2016. After obtaining approval of the institutional ethics committee, all the eligible patients were interviewed for socio-demographic variables, clinical history and examination and risk factors for COPD. Post- bronchodilator spirometry and imaging studies were performed on the study patients, based on which patients were classified as per the GOLD criteria and BODE index. Associations between various risk factors and severity of pulmonary function impairment and prognosis was analysed. Results: During the study period 50 patients were included in the study. Body mass index and two dimensional echocardiography findings of pulmonary artery hypertension were found to be significantly associated with the staging of pulmonary function according to GOLD staging criteria. Additionally, statistically significant association between BODE index and smoking index, body index and two dimensional echocardiography findings of pulmonary artery hypertension (p value less than 0.01, 0.01 and 0.05 respectively) was found. We found higher creatinine levels, leucocyte count and acute on chronic type 2 respiratory failure to be significantly associated with death. Conclusion: Patient variables have a strong association with severity and prognosis of COPD.