Impact of chronic obstructive pulmonary disease on the outcome of patients admitted to the coronary care unit

• Main Authors: Magdy M Khalil, Ibrahim A Dwedar, Mai M Abdelazeem
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Egyptian Journal of Chest Disease and Tuberculosis
• Subjects: arterial blood gases; chronic obstructive pulmonary disease; hypertension
• Online Access: http://www.ejcdt.eg.net/article.asp?issn=0422-7638;year=2019;volume=68;issue=2;spage=123;epage=128;aulast=Khalil

Background The prevalence of chronic obstructive pulmonary disease (COPD) varies between countries and age groups but is estimated to be between 15 and 20% in the European adult populations over 40 years. COPD is accompanied with increased risk of multiple, chronic comorbidities. One of those chronic illnesses that shows a higher probability to coexist with COPD is cardiovascular disease. Objective Assessment of hazards of COPD on the management and outcome of patients admitted to coronary care unit (CCU). Patients and methods A case–control study was designed between September 2015 and March 2016, including 100 consecutive patients admitted to the CCU for more than 24 h in Rail Way Hospital in Cairo, Egypt. Two groups with equal number of cases were recruited in the study (COPD patients and non-COPD patients). All of them were admitted to the CCU for more than 24 h due to several cardiac emergencies. Follow-up and monitoring the management of either COPD or non-COPD patients in CCU was done. Results Both groups were matched for age and sex. Several causes were the reason for admission to the CCU with no significant differences among both groups. No significant differences existed regarding cardiac interventions. More than 48% of the patients in the COPD group had needed to change their medications during their CCU stay which ranged from 1 to 3 agents. More patients in the COPD group required SpO2 monitoring inside the CCU (P<0.001). Also a significant number of COPD patients were exposed to repeated ischemic attacks as well as chest infection during their stay in the CCU (P=0.036, 0.001, respectively). Additionally, potassium abnormalities had been exited significantly in COPD patients compared with the non-COPD. Conclusion COPD had several cardiovascular adverse effects. Management of COPD can lead to significant ischemic attacks and serum K level abnormalities. Chest infection was a serious and frequent consequence of inflammatory cascade occurred to COPD patients admitted to the CCU. No significant difference had been existed between both groups regarding the length of hospital stay and incidence of cardiac arrhythmia.