الفهرس 
Morbidity and mortalityOnly 14 pages are availabe for public view
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Abstract
COPD is a substantially underdiagnosed disorder, with the diagnosis typically missed or delayed until the condition is advanced. Spirometry is the most frequently used pulmonary function test and enables health professionals to make an objective measurement of airflow obstruction and assess the degree to which it is reversible (Soriano et al., 2009). COPD is one of the leading causes of death in developed nations and affects both men and women. Smoking is the cause of COPD in most cases and accounts for 80% to 90% of COPD-related deaths (Torpy et al., 2010). Prevalence, morbidity and mortality in Egypt are still lacking and have to be estimated; however COPD is arising significant health problem in Egypt (Egyptian Society of Chest Diseases and Tuberculosis, 2003).
The aim of this work was to study COPD patients in Sohag Chest Hospital and Elhelal Hospital during period from April 2012 to July 2013 as regard demographic, clinical characteristic of the patients and available prescription pattern.
This study included all COPD patients either referred to outpatient chest clinic or admitted to the hospital. Diagnosis of COPD was done according to (GOLD), 2011.
All patients were subjected to:
1- Full medical history and examination.
2- Pre and post bronchodilator spirometric study according to (GOLD), 2011. In case of patients who can’t perform spirometry they were included only if there were previous spirometric documents available.
3- Questionnaire to detect epidemiology, demographic, clinical characteristic of the patients and available prescription pattern.
The mean age was 64.7 and 64.04 years in outpatient and inpatients respectively, and only 8% of studied patients were females.
The majority of COPD patients were of low social class indicated by low educational level and low employment grade.
Nearly all COPD patients were either current or exsmoker. Cigarette smoking was the most common type of smoking.
Cephalosporin, Quinolones and Macrolides were the most commonly used antibiotics in treatment of respiratory infections among studied COPD patients.
Theophylline was the most common bronchodilator prescribed, while systemic steroids were commonly used during exacerbations and for a short course.
Long acting beta2 agonist whether alone or in combination with fluticasone were the most commonly used inhalers, while short acting anticholinergic were commonly used as nebulizer.
There were small role of vaccines (6.5%) and patient education (9.3%) and no role for rehabilitation in the management of studied patients.
Hypertension and diabetes mellitus were the most common comorbidities encountered with COPD patients.
In this study, there were 11% in mild stage, 19% in moderate stage, 38% were in severe stage and 32% were in very severe stage.
Conclusions
This study revealed the importance of available accurate statistical records in Elhelal Hospital and Sohag Chest Hospital especially spirometric reports. Difference in risk factors of COPD especially smoking, reflect changes in the prevalence of COPD in different countries. There is lack of information about the outcome of referred cases due to absence of respiratory ICU in the hospital. Although the low socioeconomic state of the majority of the patients, they expend most of their income on smoking. Also the study revealed the great role of spirometry in diagnosis of COPD, and its differential diagnosis from asthma. Large numbers of COPD patients refuse inhalers. Most of the patient who use inhalers, take them in wrong manner. There is great defect in education as a non pharmacological treatment for COPD patients, inspite of its great role in management of the disease. Treatment prescription patterns were partially matching with international standards of management of COPD in acute exacerbations, but maintenance therapy is greatly affected by socioeconomic status