A NEW TOOL which helps emergency physicians identify patients with chronic obstructive pulmonary disease (COPD) who are at high risk of serious complications, including death, performs better than current practice, researchers have said. 

More commonly known as bronchitis or emphysema, COPD is a chronic lung condition whose primary symptoms are breathlessness, persistent cough and regular chest infections.

About 500,000 people in Ireland have COPD, but half of them likely do not know they have the condition.

COPD is primarily caused by smoking, but can also be the result of inhalation of dust or chemicals, or exposure to indoor or outdoor pollution, including fumes in the workplace, over an extended period of time.

A recent study, published in the Canadian Medical Association Journal, could impact how patients with COPD are treated globally. 

The study was conducted at six hospitals in Ontario and Alberta with 1,415 patients aged 50 years and older who presented at emergency departments with COPD flare-ups.

Using the 10-point Ottawa COPD Risk Scale, researchers tested whether they could accurately predict short-term serious complications in these patients.

The tool correctly predicted that 135 patients (9.5%) would have serious complications, although 65 (8.3%) of serious outcomes occurred in the 779 participants who were not admitted to hospital.

“Before this tool, there was no way to know if a patient who came to the emergency department with a COPD flare-up was going to have dangerous complications,” Dr Ian Stiell, a professor of emergency medicine at the University of Ottawa, said. 

This new information can help doctors decide whether to admit a patient or send them home.

“This should help decrease unnecessary admissions as well as unsafe discharges of patients with COPD who should be admitted,” Stiell added. 

The risk scale can be used by respirologists, general internists and family doctors who care for patients with COPD, in addition to emergency physicians.

17,500 hospital admissions 

There were more than 17,500 hospital admissions for COPD in Ireland in 2017 and it is the most common cause of disease-specific emergency admission to hospital among adults in this country. 

Professor JJ Gilmartin, Consultant Respiratory Physician and Chair of COPD Support Ireland, previously said the 500,000 figure is based on the 2011 Census and “likely to be an understatement, given that our population has gotten larger and older since then”.

Based on the most recent statistics available, Ireland has the highest hospitalisation rates for COPD of all the OECD countries.

Advice 

COPD Support Ireland, the umbrella body for 20 local COPD support groups, has issued the following advice for people living with COPD:

• Give up smoking
• Do breathing exercises and chest clearance techniques to help get rid of phlegm
• Get active: You may feel that exercise will make you even more breathless, however, the less exercise you do, the less you are able to do
• Eat well: Try to have a balanced diet and maintain a healthy weight; eat little and often rather than having big meals
• Know your medications: Talk with your health professional about your medications and how they work; make sure you are using the correct inhaler technique 
• Avoid flare-ups: Keep away from smoky environments, pollutants like dusts, smog or foggy weather, and try to minimise your risk of colds and flus, including making sure to get the flu jab every year
• Look after your mind: Living with a long-term illness is not easy and can give rise to feeling low or anxious

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