The Management and Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) at Dr. George Mukhari Academic Hospital

Introduction: Chronic obstructive pulmonary disease is a significant cause of ill-health and mortality among sufferers throughout the world.

Objective: The purpose of the study was to describe the management and outcomes of patients admitted to the medical wards of DGMAH with an acute exacerbation of COPD.

Methods: A review of the medical records of a cohort of medical patients admitted with an acute exacerbation of COPD over a 12-month period (August 2022-August 2023).

Results: A total of ninety-seven patients were studied. The mean age was 64.6 years. A quarter of the cases had more than 40 pack-year smoking history. Seventy-seven percent of the patients had one or more comorbidity. Thirty-eight patients (39.1%) had had at least one previous exacerbation requiring hospitalization in the past 12-months. More than 75% (79.4%) of the flare-ups were deemed infective in origin. Seven patients required high care admission. Eighteen patients (18.5%) succumbed in association with the exacerbations. There was no association between the presence of comorbid disease, a previous episode of an exacerbation or gender and poor outcome. There were also no significant differences noted between survivors and non-survivors with regards to mean age, mean pack year history or admission biochemical abnormalities.

Conclusion: COPD exacerbations can be associated with loss of life. This means any flare-up should be treated with the seriousness it deserves as it carries a potential for poor outcome. Most of the flare-ups were infective in origin; suggesting empiric antimicrobial coverage may be appropriate in our setting.