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Jindal SK, Aggarwal AN, Jindal A, Talwar D, Dhar R, Singh N, Singh V, Krishnaswamy UM, Chetambath R, Nath A, Bhattacharya P, Chaudhary D, Gupta PR, Gupta ML, Koul P, Swarankar R, Kant S, Ghoshal A. COPD exacerbation rates are higher in non-smoker patients in India. Int J Tuberc Lung Dis 2021; 24:1272-1278. [PMID: 33317671 DOI: 10.5588/ijtld.20.0253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is common among non-smokers exposed to solid fuel combustion at home. Different clinical characteristics in these patients may have significant therapeutic and prognostic implications.METHODS: We used medical record review and a questionnaire among COPD patients at 15 centres across India to capture data on demographic details, different types of exposures and clinical characteristics. Chest radiography and pulmonary function testing were performed in all 1984 cases; C-reactive protein and exhaled breath nitric oxide were measured wherever available.RESULTS: There were 1388 current or ex-smokers and 596 (30.0%) non-smokers who included 259 (43.5%) male and 337 (56.5%) female patients. Sputum production was significantly more common in smokers with COPD (P < 0.05). The frequency of acute symptomatic worsening, emergency visits and hospitalisation were significantly higher (P < 0.05) in non-smokers with COPD; however, intensive care unit admissions were similar in the two groups. There was no significant difference with respect to the use of bronchodilators, inhalational steroids or home nebulisation among smoker and non-smoker patients. The mean predicted forced expiratory volume in 1 sec in smokers (43.1%) was significantly lower than in non-smokers (46.5%).CONCLUSION: Non-smoker COPD, more commonly observed in women exposed to biomass fuels, was characterised by higher rate of exacerbations and higher healthcare resource utilisation.
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Affiliation(s)
| | - A N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh
| | | | - D Talwar
- Metro Centre for Respiratory Diseases, Metro Hospitals, Noida
| | | | | | | | | | | | - A Nath
- Pulmonary Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow
| | | | - D Chaudhary
- Pt BDS Postgraduate Institute of Medical Sciences, Rohtak
| | - P R Gupta
- Department of Respiratory Medicine, NIMS University, Jaipur
| | - M L Gupta
- Santokba Dabhji Memorial Hospital, Jaipur
| | - P Koul
- Shere Kashmir Medical RI, Srinagar
| | - R Swarankar
- Getwell Hospital & Research Institute, Nagpur
| | - S Kant
- Department of Respiratory Medicine, King George Medical University, Lucknow
| | - A Ghoshal
- National Asthma & Allergy Centre, Kolkata, India
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