INCIDENCE OF POLYCYTHEMIA AMONG PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE ADMITTED TO THE DEPARTMENT OF MEDICINE IN TERTIARY CARE HOSPITAL

Abstract

Background: Secondary polycythemia is a recognized hematological complication of chronic hypoxic lung disease, particularly chronic obstructive pulmonary disease (COPD). Elevated hematocrit increases whole blood viscosity and predisposes patients to thromboembolic and cardiovascular complications. Local data on the prevalence of this complication among hospitalized patients in Pakistan remain scarce. This study was conducted to determine the prevalence of polycythemia among patients with COPD and to evaluate its association with demographic and clinical characteristics.

Materials and Methods: This prospective observational study was conducted in the Department of Medicine, Federal Government Polyclinic Hospital, Islamabad, over four months. A total of 200 consecutive adult patients (aged ≥40 years) admitted with a diagnosis of COPD, defined according to GOLD spirometric criteria, were enrolled using non-probability consecutive sampling. Demographic data, smoking status, biomass fuel exposure, resting oxygen saturation, and GOLD stage were recorded. Polycythemia was defined using 2016 WHO diagnostic thresholds. Comparisons between patients with and without polycythemia were performed using the independent-samples t-test, chi-square test, or Fisher's exact test. A p-value <0.05 was considered statistically significant.

Results: Among 200 patients with COPD, the mean age was 64.8 ± 8.7 years, with a male predominance (67.0%). Polycythemia was present in 16 patients (8.0%). Polycythemia was significantly more common among males than females (93.8% vs. 64.7%; p = 0.018) and among current smokers than others (87.5% vs. 56.5%; p = 0.015). Patients with polycythemia had significantly lower resting oxygen saturation than those without (84.7 ± 2.8% vs. 89.8 ± 3.9%; p < 0.001). No significant difference was observed for age or body mass index.

Conclusion: Secondary polycythemia remains a clinically relevant complication among hospitalized patients with COPD, occurring in 8.0% of this cohort. Male sex, current smoking, and severe resting hypoxemia were the principal factors associated with its occurrence. Routine assessment of hemoglobin, hematocrit, and oxygen saturation may facilitate early identification of at-risk patients and guide timely optimization of long-term oxygen therapy and smoking cessation.