The burden of lung disease in Hong Kong: A report from the Hong Kong Thoracic Society

Chan‐Yeung, Moira; Lai, Ching‐Long; Chan, Kin‐Sang; Cheung, Amy; Yao, Tzy‐Jyun; Ho, Alice; Ko, Fanny W.; Yam, Loretta Yin‐Chun; Wong, P.S.; Tsang, K. T.; Lam, Wah‐Kit; Ho, James Chung Man; Chu, Chung‐Ming; Yu, Wai‐Cho; Chan, Hok‐Sum; Ip, Mary S.M.; Hui, David S.; Tam, Cheuk‐Yin

doi:10.1111/j.1440-1843.2008.01394.x

Cited by 30 publications

(46 citation statements)

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“…(16) A report from the UK revealed that 39% of bed days used for respiratory disease treatment are due to pneumonia and other acute lower respiratory infections. (5) A survey conducted in Hong Kong (20) showed that respiratory infections were a major cause of utilization of respiratory inpatient bed days. These differences in the ranking of respiratory diseases might be attributed to the interaction of environmental factors, smoking, HIV infection and poverty in the developing countries.…”

Section: Discussionmentioning

confidence: 99%

Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria

2009

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Objective: To determine the morbidity and mortality related to respiratory diseases among adults attending a tertiary-care hospital in Nigeria. Methods: We carried out a retrospective study of 183 adult patients (> 15 years of age), diagnosed with respiratory diseases between November of 2006 and October of 2008 at the Federal Medical Centre in Ido-Ekiti, Nigeria. Results: Of the 183 patients enrolled in the study, 78 (42.6%) were male and 105 (57.4%) were female, the male:female ratio being 1:1.4. Respiratory diseases were predominant in the 25-44 year age bracket (37.2%) and lower socioeconomic class (81.4%). Pulmonary TB was the leading cause of morbidity (in 42.1%), followed by asthma (in 17.5%) and pneumonia (in 15.3%). Lung cancer was uncommon (in only 0.6%). Pulmonary TB was the leading cause of hospitalization for respiratory disease (in 32%). Pulmonary TB, asthma, pneumonia and pleural pathologies were more common in women, whereas COPD was more common in men. The most common comorbidity was HIV infection (in 11.5%). The overall mean length of hospital stay was 14 days. Overall mortality was 8.7%; 50% of the deaths were attributed to pulmonary TB, 25% were attributed to pleural disease, 12.5% were attributed to pneumonia, and 6.25% were attributed to acute exacerbation of COPD. Mortality was higher in women and in the 25-44 year age bracket. Conclusions: Pulmonary TB, asthma and pneumonia were the leading causes of respiratory disease-related morbidity. Pulmonary TB was the leading cause of respiratory disease-related mortality among the adult Nigerians evaluated. Therefore, these conditions should be given higher priority in patient care. In addition, antiretroviral therapy should be readily accessible and affordable to HIV-infected individuals.Keywords: Morbidity; Mortality; Respiratory tract diseases; Africa. ResumoObjetivo: Determinar a morbidade e a mortalidade relacionadas a doenças respiratórias em adultos atendidos em um hospital terciário na Nigéria. Métodos: Estudo retrospectivo com 183 pacientes adultos (> 15 anos) diagnosticados com doenças respiratórias, entre novembro de 2006 e outubro de 2008, no Centro Médico Federal em Ido-Ekiti, Nigéria. Resultados: Dos 183 pacientes estudados, 78 (42,6%) eram do sexo masculino e 105 (57,4%) do sexo feminino (razão entre homens e mulheres: 1:1,4). As doenças respiratórias foram predominantes na faixa etária entre 25 e 44 anos (37,2%) e classe socioeconômica baixa (81,4%). A forma pulmonar da TB foi a principal causa de morbidade (em 42,1%), seguida por asma (em 17,5%) e pneumonia (em 15,3%). O câncer de pulmão foi raro (em somente 0,6%). A TB pulmonar foi a principal causa de hospitalização devido à doença respiratória (em 32%). A forma pulmonar da TB, asma, pneumonia e patologias da pleura foram mais frequentes no sexo feminino, ao passo que a DPOC foi mais frequente no sexo masculino. A comorbidade mais frequente foi a infecção por HIV (em 11,5%). A média do tempo de hospitalização foi de 14 dias. A mortalidade foi 8,7%; 50% das mortes foram ...

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Section: Discussionmentioning

confidence: 99%

Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria

2009

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“…The exclusion criteria for patients comprised: (1) no family caregiver at home (n ¼ 597); (2) inability to speak the Cantonese dialect or lack of a permanent residence in Hong Kong (n ¼ 90); and (3) failure to perform the spirometry test (n ¼ 10).…”

Section: Participantsmentioning

confidence: 99%

“…Silicosis results from the inhalation of silica dust from mines and quarries, 1 and is the most common type of pneumoconiosis in Hong Kong. Its main symptoms include coughing and shortness of breath, and its complications include emphysema and tuberculosis.…”

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confidence: 99%

Caregiving burden and quality of life of pneumoconiosis caregivers in Hong Kong

et al. 2011

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“…2 A territory-wide survey of the burden of lung disease in Hong Kong in 2005 showed that COPD was the second most common respiratory cause of hospitalisation (accounting for 14.6% of admissions and 20.5% of in-patient bed-days). 3 However, the hospitalisation data of that 2005 survey only included the principal diagnosis on discharge. There was no information on the severity of airflow limitation, co-morbidities, admission pattern, or long-term treatments.…”

Section: Introductionmentioning

confidence: 99%

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

Au¹,

Chan²

2013

Hong Kong Med J

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Objective To assess the disease spectrum, severity of airflow limitation, admission pattern, co-morbidities, and management of patients admitted for acute exacerbations of chronic obstructive pulmonary disease. Design Case series.Setting An acute regional hospital in Hong Kong.Patients Adult subjects admitted during January 2010 to December 2010 with the principal discharge diagnosis of chronic obstructive pulmonary disease. ResultsIn all, the records of 253 patients with physician-diagnosed chronic obstructive pulmonary disease were analysed. The majority were old (mean age, 78 years). The median number of admissions per patient for this condition in 2010 was two. About two thirds (64%) had had spirometry at least once. Mean forced expiratory volume in one second predicted was 55%. Almost 90% had moderate-to-very severe airflow limitation by spirometry. Overall, long-acting bronchodilators (beta agonists and/or antimuscarinics) were being prescribed for only 21% of the patients. ConclusionMost of the patients admitted to hospital for acute exacerbations of chronic obstructive pulmonary disease were old, had multiple co-morbidities, and the majority had moderate-to-severe airflow limitation by spirometry. Almost half of them (around 46%) had two or more admissions in 2010. Adherence to the latest treatment guidelines seemed inadequate, there being a low prescription rate of long-acting bronchodilators. Chronic obstructive pulmonary disease patients warranting emergency admissions are at risk of future exacerbations and mortality. Management by a designated multidisciplinary team is recommended. Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital O R I G I N A L A R T I C L E LH Au HS Chan 區力行陳學深New knowledge added by this study • Almost 90% of chronic obstructive pulmonary disease (COPD) subjects with spirometry performed had moderate-to-very severe disease when hospital admission ensued. • About half of these patients had two or more admissions in 1 year.• Despite the severity of their illness, long-acting bronchodilators were underused by these Hong Kong COPD patients.• Long-term oxygen therapy and non-invasive ventilation (acute and long term) were used by significant numbers of patients with severe-to-very severe disease. Implications for clinical practice or policy• As many COPD patients warranting hospital admissions were already at high risk, preferably they should be managed by a multidisciplinary team in a designated respiratory or COPD ward.• Patients with a clinical diagnosis of COPD should have confirmatory spirometry.• Patients with moderate-to-severe COPD disease warrant planned interventions (including use of long-acting bronchodilators) to reduce future exacerbations and hospital admissions.• COPD patients with hypercapnic respiratory failure are at risk of mortality, and if feasible, should be managed by trained staff in a dedicated team.

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The burden of lung disease in Hong Kong: A report from the Hong Kong Thoracic Society

Abstract: Respiratory disease is responsible for the highest health-care burden locally. Increased efforts in improving management and prevention of these diseases, including tobacco control, improving air quality and vaccination against influenza and pneumococci, are necessary.

Cited by 30 publications

References 104 publications

Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria

Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria

Caregiving burden and quality of life of pneumoconiosis caregivers in Hong Kong

Severity of airflow limitation, co-morbidities and management of chronic obstructive pulmonary disease patients acutely admitted to hospital

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