A clinical study of COPD in elderly with special reference to HRCT chest and PFT

Background: Chronic Obstructive Pulmonary Disease (COPD) is defined as a preventable and treatable lung disease with some significant extra-pulmonary effects. Pulmonary component is characterized by airflow limitation that is not fully reversible, usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles and gases. Elderly patients are more prone to COPD due to the reduction in the immune power along with the muscle weakness of the chest wall and bone weakness. Aim and objectives: To study the COPD in elderly with reference to HRCT chest and PFT, to study the pattern of pulmonary involvement in COPD in elderly. Materials and methods: It was Prospective observational study. Study population was elderly patients (age ≥60 years) detected having COPD (both in-patient and out-patient) attending MGM Hospital for treatment. Detailed history was taken from patient, particularly history of symptoms like fever, cough, shortness of breath, weight loss, night sweat etc. Thorough physical examination of all the systems with special emphasis on respiratory system was done. Results: Total 50 patients were enrolled in the study. Majority of the patients (44%) were in the age group of 60-70 years followed by 32% in the age groups of 70-80 years and 24% patients in the age group of >80 years. The mean age of the patients was 72.76±7.58 years. There was male preponderance (72%) in the study. Majority of the male patients were smokers (61%). Dyspnoea (76%), cough (68%), sputum production (64%) were the common symptoms. Centriacinar emphysema (34%) was mostly observed. FEV1/FVC ratio ranged from 38-89% (mean 62.9+/-18.52%) preinhalation, ranged from 45% to 90% (mean 69.26±15.08) post-inhalation. Conclusion: HRCT showed regional assessment of compartment involved and has greater sensitivity than chest radiography in early diagnosis of emphysema.