I found this interesting because they indicated that people with this condition (also known as Pickwickian syndrome) 43% were misdiagnoised as having COPD. It may not be that high. I have included the signs and symptom at the bottom.
The outcome is serious if left untreated. Another condition that gets lumped in under COPD rather than investigated.
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Obesity hypoventilation syndrome often misdiagnosed, affecting mortality
Many patients with obesity hypoventilation syndrome are misdiagnosed as having other respiratory conditions and receive inappropriate therapy, likely contributing to a high mortality rate, according to recent findings.
“The high overall mortality of patients with [obesity hypoventilation syndrome] in our study is alarming,” wrote Paul E. Marik, MD, FCCP, FCCM, professor of medicine and chief of the division of pulmonary and critical care medicine at Eastern Virginia Medical School, and Catherine Chen, MD, resident at Eastern Virginia Medical School. “The 3-year mortality for [obesity hypoventilation syndrome] in our cohort is worse than the current 5-year survival in the USA for breast cancer, colon cancer and prostate cancer and similar to that for all cancers combined. ... A number of factors likely contributed to the high mortality of patients ... however, the misdiagnosis of [obesity hypoventilation syndrome] with inappropriate therapy likely played a major role.”
In a retrospective study, Marik and Chen analyzed electronic records data from 600 patients with “unequivocal” obesity hypoventilation syndrome admitted to Sentara Norfolk General Hospital in Virginia, a tertiary-care teaching hospital, between 2009 and 2013. Included patients had a BMI of at least 40 kg/m², elevated arterial carbon dioxide tension (PaCO), were nonsmokers or smoked fewer than 20 packs per year, and had no evidence of intrinsic pulmonary disease (64% women; 45% white; mean age, 58 years; mean BMI, 48.2 kg/m²; 37% with history of diabetes). Researchers linked the database to available death certificate data.
Researchers found that 43% of patients were misdiagnosed as having chronic obstructive pulmonary disease (mean presenting PaCO, 55.6 mm Hg; mean serum creatinine, 1.59 mg/dL), whereas none had been previously diagnosed with obesity hypoventilation syndrome. The most common admission diagnoses were respiratory failure, heart failure and sepsis; 90 (15%) patients died during the index hospitalization.
The patients’ age, serum creatinine, respiratory failure, sepsis and admission to the
ICU were independent predictors of hospital and posthospital mortality. After a mean 3.2 years of follow-up, 98 of the 510 (19%) hospital survivors died, with an overall cumulative mortality of 31.3%.
“Serum bicarbonate greater than 27 mmol/L is a sensitive and inexpensive marker of established [obesity hypoventilation syndrome] as well as ‘early’ [obesity hypoventilation syndrome],” the researchers wrote. “All patients with a BMI > 35 kg/m² should be screened for [obesity hypoventilation syndrome] using this simple test. Patients with [obesity hypoventilation syndrome] should be referred to a pulmonary and/or sleep specialist for evaluation for [noninvasive positive pressure ventilation], to a dietitian for dietary counseling and lifestyle modification and to a bariatric surgeon for evaluation.” – by Regina Schaffer
www.healio.com/endocrinology/obesity/news/online/%7B1c417ef6-5883-4fb3-91d5-3af6aa4ca579%7D/obesity-hypoventilation-syndrome-often-misdiagnosed-affecting-mortality
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No sense warning people without telling them what to watch for!!!--------------------------
Signs and symptomsMost people with obesity hypoventilation syndrome have concurrent obstructive sleep apnea, a condition characterized by snoring, brief episodes of apnea (cessation of breathing) during the night, interrupted sleep and excessive daytime sleepiness. In OHS, sleepiness may be worsened by elevated blood levels of carbon dioxide, which causes drowsiness ("CO2 narcosis"). Other symptoms present in both conditions are depression, and hypertension (high blood pressure) that is difficult to control with medication.[1] The high carbon dioxide can also cause headaches, which tend to be worse in the morning.[4]
The low oxygen level leads to excessive strain on the right side of the heart, known as cor pulmonale.[1] Symptoms of this disorder occur because the heart has difficulty pumping blood from the body through the lungs. Fluid may therefore accumulate in the skin of the legs in the form of edema (swelling), and in the abdominal cavity in the form of ascites; decreased exercise tolerance and exertional chest pain may occur. On physical examination, characteristic findings are the presence of a raised jugular venous pressure, a palpable parasternal heave, a heart murmur due to blood leaking through the tricuspid valve, hepatomegaly (an enlarged liver), ascites and leg edema.[5] Cor pulmonale occurs in about a third of all people with OHS.[2]
en.wikipedia.org/wiki/Obesity_hypoventilation_syndrome
