Background: Chronic obstructive pulmonary disease (COPD) exacerbation contributes to the severity and progression of COPD. It is necessary to study on the factors associated with exacerbation of COPD in Indonesia. Objective: To determine the prevalence of COPD exacerbations in Cipto Mangunkusumo Hospital (CMH), Jakarta during 2010 until 2012 and to identify factors associated with COPD exacerbation of patients in CMH. Methods: Cross-sectional study was carried on COPD patients in CMH during 2010-2012. Clinical, supportive, and outcome data were obtained from medical records. Bivariate analysis was performed on age, history of smoking, comorbidity, severity of COPD, corticosteroid treatment, and frequency of exacerbations in past year. Eligible variables were then included in the multivariate analysis using logistic regression.
Results: A total of 184 patients enrolled in this study. Prevalence of COPD exacerbation was 70.7%. From bivariate analysis, severity of COPD, history of smoking, frequency of exacerbation in past year, history of systemic corticosteroid treatment, age, and comorbidity were eligible for multivariate analysis. Significant independent risk factors included ≥2 times of COPD exacerbation in the previous year (OR 27.39; CI95% 3.30-227.29; p=0.002), current smoker (OR 5.11; CI95% 1.07-24.35; p=0.04), grade III and IV COPD (OR 4.71; CI95% 1.59-13.97; p=0.005), and comorbidity with Charlson Comorbid Index >2 (OR 4.09; CI95% 1.37-12.18; p=0.01). Systemic corticosteroid is protective against COPD exacerbation (OR 0.12; CI95% 0.03-0.54; p=0.01).
Conclusion: The prevalence of COPD exacerbations in RSCM during 2010-2012 is 70.7%. Risk factors for COPD exacerbation included exacerbation in the previous year, current smoker, grade III and IV COPD, and comorbidity, while systemic corticosteroid is protective factor.
Keywords: COPD exacerbation, risk factor, protective factor.