Factors affecting the outcomes in stable chronic obstructive pulmonary disease patients at an Army Central Hospital

Abstract

Background: Of the four Asian countries, Indonesian COPD patients have the worst clinical features, which puts them at a high risk for treatment failure. There are a number of variables and patient traits that influence clinical results as a predictor of therapy outcomes. Objective: to identify the contributing components and how much they influence COPD patients’ therapy results. Methods: This cross-sectional descriptive-observational study at a tertiary army hospital involved 74 patients. A questionnaire and medical records were utilized to obtain sociodemographic characteristics and clinical data. Correlation and logistic regression analysis were conducted to identify significant factors. Results: The results showed that tumor/cancer comorbidities affected the worsening of CAT values (OR=10.89, 95%CI=1.01-117.23, p=0.049), use of ICS/LABA drugs affected the improvement of mMRC values (OR=0.26, 95%CI=0.08-0.84, p=0.024), history of TBC disease affected the increase in exacerbation severity (OR=7.25, 95%CI=1.05-50.23, p=0.045), age from smoking >20 years affected the reduction in exacerbation severity (OR=0.03, 95%CI=0.002-0.61, p=0.022). History of alcohol use (OR=7.26 and 167.56, p=0.014 and 0.004) and comorbid pneumonia (OR=28.14 and 44.25, p=0.035 and 0.014) contributed to an increase in the frequency of exacerbations and hospitalization per year. Medium economic status affects the decrease in hospitalizations per year (OR=0.06, 95%CI=0.00-0.91, p=0.043) while the diagnosis of severe COPD and history of alcohol affected the decrease in COPD severity (ABCD) (OR=0.12 and 0.24, p=0.039 and 0.009). Conclusion: comorbidities, disease history, history of alcohol use, COPD status and the use of COPD medications contributed to variations therapeutic outcomes COPD patients. Therefore, it must be taken into account when making clinical decisions.