Chronic Obstructive Pulmonary Disease COPD patient treatment tactics

Chronic Obstructive Pulmonary Disease (COPD) patient treatment tactics and its results at the Emergency Medical Center (NMC) stage ID 24689 Emergency Medicine resident Milana Karpova, student of RSU faculty of Medicine Romans Uljanovs Head of P. Stradiņš Clinical University Hospital (PSKUS) Pulmonary Diseases and Thoracic Surgery Center Dace Žentiņa Introduction During this study an apprehension was gained of medications used to treat COPD exacerbations before hospitalization in PSKUS internal medicine department or discharge to outpatient care. Obtainet data were compared to GOLD recommendations and studies performed in other world hospitals. Overall 16 (32. 7%) patients had first time COPD diagnosis, 11 (22. 4%) patients had recurrent exacerbations in the last month and 13 (26. 5%) patients had not been hospitalized for a time period greater than 12 months. Aim. Evaluate whether existing treatment tactics at PSKUS NMC stage meet the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Materials and Methods. The study was conducted at PSKUS, analyzing case records of patients that were hospitalized with a referral from the Emergency Medical Service (NMPD), family doctor or arrived themselves with acute shortness of breath. From 01. 08. 2018 until 22. 11. 2018 for a total of 16 weeks, all hospitalization cases in NMC were examined, and case records that after primary inspection, additional examinations and treatment were encoded by the physician with (SSK-10) J 44 - Chronic Obstructive Pulmonary Disease. Obtained data were processed with Microsoft Excel and SPCC_Statistics. Results were compared with GOLD recommendations. Results. A total of 49 patients were involved in the study: 15 (30. 6%) women, 34 (69. 4%) men. Of these, 23 (46. 9%) were hospitalized in therapeutic departments, 2 (4. 1%) in intensive care units and 24 (49%) discharged for outpatient treatment. Hospitalization count per patient during last year 33% of respondents with confirmed COPD did not use or used medications irregularly. The study determined a connection between patients that were hospitalized more than 5 times during last year and disuse of medications. There were 23 (46. 9%) patients that used medications on a regular basis and 16 (32. 7%) patients that were not taking any medications or using them occasionally. Most common drugs used to treat COPD exacerbations at the NMC stage were: 29 (59. 2%) - Salbutamol, 26 (53. 1%) Berodual, 23 (46. 9%) - Dexamethasone, 13 (26. 5%) ) Solumedrol, 5 (10. 2%) - Magnesium sulfate, 6 (12. 2%) cases - Ambroxol, 16 (32. 7%) cases - Sophafyllin, 25 (51%) cases - other medications. . Last hospitalization Conclusion. PSKUS NMC patients with COPD exacerbations received treatment according to GOLD recommendations, but a tendency to use additional agents such as Magnesium Sulphate, Ambroxol, Sophafyllin exists, which have not have proven their effectiveness in other studies on COPD exacerbations. According to literature data, up to 80% of patients with COPD can continue outpatient treatment, in our study it reached only 49%, which can be explained by poor patient compliance.