الفهرس 
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Abstract
COPD is the most common chronic lung disease in the world and is a major cause of morbidity and mortality worldwide. COPD poses a common growing and significant clinical challenge for patients and clinicians‘ expert knowledge regarding diagnosis and management.
The aim of this study was to study prevalence of different comorbidities in COPD patients in El- Mahalla Chest Hospital in the period from January 2018 to December 2018. In this study, 188 patients fulfilled the diagnostic criteria of COPD based on symptoms and spirometry according to GOLD 2018 was included in the current study.
All patients subjected to:
1. Full medical history, general and local examination.
2. Pre and post bronchodilator spirometric study
3. Each patient subjected to questionnaire to detect epidemiology, demographic, clinical characteristic of the patients.
4. Each patient subjected to questionnaire of charlson comorbidity score.
The age of studied patients ranged from 42- 75 years old and the mean and standard deviation was (57.511 ± 7.262). As regard sex 70.21% were males and 29.78% were females. As regard residence the studied cases who lived in rural areas (54.79 %) more than whom lived in urban areas (45.21 %).
Most of COPD patients were exposed to organic and inorganic dust in their occupation. Farmers were more frequent (37.23%) then bakers (10.64%) then carpenters (7.98%) then housewives (6.38%) and the rest other manual jobs represented (37.77%).
Summary
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The smoking history of the studied patients in this study revealed 113 smokers (60.10 %), 56 non-smokers (29.87 %) and 19 ex-smokers (10.10 %). The mean number of packs per year was 45.124 ± 22.059 pack/year.
As regard symptom, all studied patients had dyspnea and most of patients complained from cough with expectoration and wheezy chest.
Hypertension and DM were the most comorbidities among studied cases. Prevalence of HTN was 54.78 % while prevalence of DM was 38.82 %.
Regarding BMI, overweight and obese patients were more frequent (42.54 %) while 23.93 % of studied patients were underweight and 33.51 % of studied patients had normal weight.
As regard COPD patients classificstion, studied patients were divided according to spirometric severity according to GOLD 2018 to mild (10 patients) which represented 5.32%, moderate (38 patients) which represented 20.21%, severe (80 patients) which represented 42.55%, and very sever (60 patients) which represented 31.91% and were divided according to ABCD GOLD groups to GOLD A (14 patients) which represented 7.44%, GOLD B (34 patients) which represented 18.08%, GOLD C (95 patients) which represented 50.53%, and GOLD D (45 patients) which represented 23.93%. They also were divided according to charlson Score to Score ≤ 1 (75 patients) which represented 39.89%, Score=2 (84 patients) which represented 44.68%, Score ≥3 (29 patients) which represented 15.42%.
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It was found that:
There was highly significant difference between Spirometric severity grades regarding ABCD GOLD groups.
There was highly significant difference between ABCD GOLD groups regarding age.
There was highly significant difference between ABCD GOLD groups regarding smoking history.
There was no significant difference between ABCD GOLD groups regarding BMI.
95 % of studied patients had different comorbidities and the more frequent comorbidity was hypertension (54 %) followed by diabetes mellitus (38 %) then anemia (28 %).
There was significant difference between CCI regarding ABCD GOLD groups.
There was significant difference between spirometric severity grades regarding CCI.
There was significant difference between ABCD GOLD groups regarding CCI.
There was highly significant difference between CCI regarding prevalence of anemia, hypertension & obesity and there was significant difference between CCI regarding prevalence of GERD and cor-pulmonale
There was significant difference between ABCD GOLD groups regarding prevalence of anemia and GERD.