Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Cause of Death in COPD Patients of a Referral Hospital

만성폐쇄성폐질환 환자 사망 원인 - 한 3차 병원 연구

  • Kim, Beom Jun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Sang Bum (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lim, Chae Man (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Do (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koh, Younsuck (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Woo Sung (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Soon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Won Dong (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Yeon-Mok (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine)
  • 김범준 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 홍상범 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 심태선 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 임채만 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 이상도 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 고윤석 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 김우성 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 김동순 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 김원동 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터) ;
  • 오연목 (울산대학교 의과대학 서울아산병원 호흡기내과, 만성기도 폐쇄성질환 임상연구센터)
  • Received : 2006.02.02
  • Accepted : 2006.04.28
  • Published : 2006.05.30
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Abstract

Background : Although 17% of Korean adults over the age of 45 years have chronic obstructive pulmonary disease (COPD), there is only limited data on the cause of death in COPD patients in Korea. Therefore, this retrospective study was performed to examine the cause of death in COPD patients at a referral hospital in Korea. Methods : The medical records of 28 deceased patients diagnosed as COPD in Asan Medical Center from January to December 2003 were reviewed patients had died in Asan Medical Center and 16 patients had died outside the hospital. The Korean National Statistical Office confirmed 88 deceased patients out of 1,078 patients diagnosed as COPD in Asan Medical Center in 2003. After excluding those with tuberculous destroyed lung, bronchiectasis, and lung cancer, 28 COPD patients were evaluated. Results : The causes of death were pulmonary disease including pneumonia in 16 patients (57%), cardiac disease in 5 patients (18%), sudden death in 3 patients (11%), and other causes in 4 patients (14%). The cause of death was pulmonary disease in 83% (10 out of 12 patients) and 38% (6 out of 16 patients) of patients who died in Asan Medical Center and outside the center, respectively (P=0.05). The cause of death was pulmonary disease in 43% of patients with $FEV_1$ more than 50 % of the predicted value and in 55% of patients with $FEV_1$ less than 50 % of the predicted value (P=0.89). Conclusion : Pulmonary disease is the leading cause of death in COPD patients in Korea.

연구 배경 : 만성폐쇄성폐질환(COPD)은 45세 이상의 성인에서 국내 유병률 17.2%로 주요 질환이다. 하지만, 국내 COPD 환자의 사망원인에 대한 연구는 불충분한 상황이다. 이에 국내 COPD 환자 사망원인에 대해서 알아보고자 서울아산병원 의무기록을 후향적으로 조사하였다. 방 법 : 2003년 1년간 서울아산병원에서 COPD로 진료한 1,078명의 사망여부를 통계청에 의뢰하여 총 사망자 88명을 얻었고 이중 폐결핵 후유증, 기관지확장증, 폐암 등 암 환자를 제외한 후 남은 28명의 COPD 환자 대상으로 사망원인을 분석하였다. 결 과 : COPD 환자의 사망원인은 폐렴 등 호흡기 원인이 16명 (57%), 심장 원인 5명 (18%), 급사 3명 (11%), 기타 4명 (14%) 등이었다. 서울아산병원 내에서 사망한 환자와 외에서 사망한 환자의 호흡기 관련 사망이 각각 83%(10명/12명)과 38%(6명/16명)이었다 (P=0.05) $FEV_1$이 50%예측치보다 큰 환자와 작은 환자의 호흡기 관련 사망은 각각 43%과 55%이었다 (P=0.89). 결 론 : 국내 3차 병원에서 진료하는 COPD 환자의 사망 원인은 폐렴 등 호흡기 원인 다수를 차지한다.

Keywords

References

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