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. 2015 Nov-Dec;32(6):578-83.
doi: 10.4103/0970-2113.168132.

Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease

Dipti Gothi  1 , Shiv Sagar Gupta  2 , Nishith Kumar  3 , Kartik Sood  4
Affiliations

Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease

Dipti Gothi et al. Lung India. 2015 Nov-Dec.

Abstract

Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known.

Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome.

Materials and methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome.

Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m(2) and 31.82 ± 5.80 kg/m(2) (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001).

Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

Keywords: Acute exacerbation of COPD; metabolic syndrome; obesity; obstructive sleep apnea syndrome.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Chart 1
Chart 1
Distribution of cases in two groups according to severity of exacerbations Group I = Only COPD, Group II = Overlap
Chart 2
Chart 2
Comparison of cases in two groups according to oxygen saturation findings Group I = Only COPD, Group II = Overlap
Chart 3
Chart 3
BMI Category in both the groups Group I = Only COPD, Group II = Overlap
Chart 4
Chart 4
Distribution of cases in two groups according to blood sugar and lipid parameters Group I = Only COPD, Group II = Overlap
See this image and copyright information in PMC

References

    1. Sanders MH, Newman AB, Haggerty CL, Redline S, Lebowitz M, Samet J, O’Connor GT, et al. Sleep Heart Health Study. Sleep and sleep-disordered breathing in adult with predominantly mild obstructive airway disease. Am J Respir Crit Care Med. 2003;167:7–14. - PubMed
    1. Lee R, McNicholas WT. Obstructive sleep apnea in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med. 2011;17:79–83. - PubMed
    1. Zamarrón C, García Paz V, Morete E, del Campo Matías F. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences. Int J Chron Obstruct Pulmon Dis. 2008;3:671–82. - PMC - PubMed
    1. Minai OA, Ricaurte B, Kaw R, Hammel J, Mansour M, McCarthy K, et al. Frequency and impact of pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am J Cardiol. 2009;104:1300–6. - PubMed
    1. Hawryłkiewicz I, Sliwiński P, Górecka D, Pływaczewski R, Zieliñski J. Pulmonary haemodynamics in patients with OSAS or an overlap syndrome. Monaldi Arch Chest Dis. 2004;61:148–52. - PubMed