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Lung India Official publication of Indian Chest Society  
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Year : 1984  |  Volume : 2  |  Issue : 1  |  Page : 76-83

Behaviour On Follow-Up In Chronic Obstructive Pulmonary Disease

Correspondence Address:
S. R Kamat

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Source of Support: None, Conflict of Interest: None

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In 1981-82, 258 patients seen regularly for a long time in chest clinic were analysed for correlation of lung function with pO2 and pCO2. There was preponderance of older males, 85.7% had both cough and dyspnoea. The females were fewer and had milder grades of exertional dyspnoea. Of these 31.8% developed cor pulmonale over the follow-up. Radiologically over inflation, evidence of pulmonary hypertension or cardiac enlargement were commoner with cor pulmonale. Those with more severe dyspnoea had greater expiratory obstruction, but bronchoreversibility was similar in all grades of dyspnoea. The former showed significantly lower pO2, particularly when cor pulmonale also coexisted. The relationship between pO2 and FEV1 was linear while that between pCO2 and FEV1 was curvilinear. Of this group, an attempt to trace 85 patients was made; 9 (10%) had died, and 26(31%) could not be reached. Those assessed more regularly had a history of milder smoking. The defaulting group had a shorter history, less frequent paroxysmal and milder exertional dyspnoea, and had a slower progress. Those coming more regularly were controlled better. Those with higher initial FEV1 values showed a significant decline, while those with lower values did not show a decline. The defaulting groups showed larger declines. There were more fluctuating functional changes in the regular group, particularly females. The declines in FVC or FEV1/FVC% values were less obvious. Thus more regular treatment was taken by frequently disabled patients which appeared to keep them in better clinical and functional status over long periods.

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