The Findings on Initial Admission Chest Radiograph of Patients Presenting with an Acute Exacerbation of COPD – A South African Study

摘要

Introduction: Despite the recognition that infections (including both viral and/or bacterial) play an important role in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) there have been relatively few studies documenting the radiological changes in patients hospitalized with an AECOPD, which was the aim of the current study. Methods: This was a retrospective record review of consecutive hospitalized cases admitted to the Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa, between June 2011 and February 2013, in whom an admission chest radiograph was available for review. Results: Overall 34 patients were entered into the study. Evidence of hyperinflation was documented in 29 of 33 cases (87.9%). In 2 cases hyperinflation was the only radiological finding. Additional abnormalities noted on the chest radiographs (sometimes multiple) were as follows: parenchymal changes in 24, interstitial changes in 4, and pleural changes in 8 cases. Eleven patients (33%) had evidence of consolidation on the chest radiograph, compatible with a diagnosis of pneumonia although this had not been documented clinically. Conclusion: This study documents a considerable number of chest radiographic changes in patients presenting with acute exacerbation of COPD. Changes compatible with community acquired pneumonia (CAP) were documented in 33.3% of cases, which was not clinically evident in any of these cases.