Severe Hypoalbuminemia is a Strong Independent Risk Factor for Acute Respiratory Failure in COPD Patients Admitted in K R Hospital, Mysuru.

Background: “Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production and/or exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction”. (1) A high fatality rate is associated with severe exacerbations of COPD, which are harmful to quality of life. They raise the strain on the healthcare system and are associated with cardiovascular problems. (2) In the world, COPD ranked fourth leading cause of death (5.1%) in 2004 and is expected to rise to third (8.6%) by 2030. One of the main reasons for persistent morbidity is COPD and by 2030, it is expected to climb to sixth place. According to a countrywide survey using questionnaires, 3.49% of Indians are thought to have COPD. (3) Severe exacerbations of chronic obstructive pulmonary disease are frequently associated with life-threatening acute respiratory failure, or ARF. (4) Low albumin levels indicate malnutrition in COPD patients and it is linked to a greater death rate. In patients with chronic conditions, hypoalbuminemia is the result of poor protein and calorie intake mixed with the effects of inflammation. (4,5) This investigation seeks to ascertain if hypoalbuminemia in COPD patients is a risk factor for developing ARF. Methods: A total of 73 patients who were hospitalized due to an acute exacerbation of COPD were chosen. Arterial blood gas analysis was done and patients with PCO2 levels more than 45 mmhg were considered to be in acute respiratory failure (type II). Out of these 37 subjects was in acute respiratory failure (type II), rest 36 subjects were not in respiratory failure and serum albumin level was also estimated and was compared in both these groups and was examined using the chi square test and independent sample t test. Results: Out of the 73 patients with acute exacerbation of COPD 37 subjects were in acute respiratory failure (type II) and 36 subjects were not in acute respiratory failure. Among those most of the subjects (98%) with hypoalbuminemia had acute respiratory failure, the association was significant statistically (p-value < 0.0001). Conclusion: Because hypoalbuminemia is a potent independent risk factor for acute respiratory failure (type II), it is possible to predict that patients with COPD with hypoalbuminemia will have respiratory failure. [ABSTRACT FROM AUTHOR]