Risk Factors for Chronic Obstructive Airway Disease: A Hospital Based Prospective Study in Rural Central India

Background: Chronic obstructive pulmonary disease affected 215 million populations worldwide in 2016 and more than 90% deaths occur in low and middle-income countries. Only few studies have looked at this problem with rural perspective. This study aims to find prevalence of risk factors in COPD (chronic obstructive pulmonary disease) patients at tertiary care centre which mainly caters rural population. Material and Methods: This is a hospital-based longitudinal cohort study conducted at a rural based tertiary care Medical Institute in central India. Patient with history of cough and breathlessness for 3 months or more were studied. Spirometry-confirmed 113 COPD patients were studied for risk factors like male sex, advancing age, smoking, indoor air pollution and baseline assessment was done with Clinical COPD Questionnaire (CCQ). Result: Total 113 patients [median age, 59 y (interquartile range [IQR] 50-66); [82 (72.6% men and 31 (27.4%) women]) were included in study. Severity of COPD was not linearly correlated with the severity of risk factors like male sex (p=0.99), advancing age (p=0.70), smoking (p=0.78) and indoor air pollution (p=0.82). Low BMI (Body mass index) (18.1 Vs 20.1 Kg/m(2), p<0.01) was associated with severity of COPD. Women tended to spend more time in house (p<0.01) and Indoor risk time product grade was significantly higher in females (grade 4 indoor risk time product 30.9 vs 13.2, p=0.01). The CCQ score had an inverse relationship with baseline FEV1 (Forced expiratory volume in one second) [Pearson coefficient -0.33 (p=0.003)]. There was moderately strong relationship between decline in FEV1 and decline in PEFR (peak expiratory flow rate) (r=0.66). Conclusion: The CCQ may be used as low-cost and non-instrument-based indicator of FEV1 and PEFR to determine the severity of COPD at baseline as well as to judge improvement from baseline. CCQ score would be useful where spirometry is not available.