Comorbidities and their impact on chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex disease that is associated with devastating outcomes resulting from lung involvement and several comorbidities. Comorbidities could impact on symptomology, quality of life, the complications, the management, economic burden and the mortality of the disease. The importance of comorbidities originates from their impact on the outcome of COPD. The most frequent comorbidities in COPD are cardiovascular, endocrinological, musculoskeletal, phycological disorders and lung cancer. Almost 50% of the COPD patients have 3 or more comorbidities. The recent Global Initiative of Obstructive Lung Disease (GOLD) Guideline suggested proactive search and the treatment of the comorbidities. However, there is no certain evidence demonstrating that active treatment of comorbidities improve the outcomes of COPD. However, it is well known that several comorbidities such as cardiovascular disease and lung cancer have greater impact on mortality caused by COPD. Several studies have shown that Charlson Comorbidity index or more recenty COPD Specific Comorbidity Index (COTE) has been found to be related with mortality of COPD. This concise review intended to summarize the most frequent comorbidities in association with their impact on COPD.

Comorbidity phenotypes and risk of mortality in patients with ischaemic heart disease in the UK

“…There is a paucity of studies examining the coexistence of cardiovascular, respiratory and musculoskeletal conditions with mortality in patients with IHD; however, others have reported that patients with a high prevalence of both cardiovascular and musculoskeletal conditions have higher mortality compared with those without any major disease conditions 16. Furthermore, other studies have shown that patients with COPD have a high prevalence of other cardiovascular comorbidities17 or go on to be diagnosed with them 18 19. Musculoskeletal conditions such as osteoarthritis and IHD share some common risk factors such as a higher BMI and physical inactivity,20 and patients with CVD and comorbid arthritis have reduced capacity for exercise compared with those without comorbidity 21.…”

Comorbid Metabolic Disorders in Chronic Lung Diseases

“…Хронічні хвороби легень, як-от бронхіальна астма (БА), хронічне обструктивне захворювання легень (ХОЗЛ) та інтерстиційні захворювання легень (ІЗЛ), є складними розладами, для яких відзначається стабільне підвищення захворюваності, смертності й економічних втрат [1]. Ведення цих хвороб потребує мультидисциплінарного підходу включно з обстеженням на наявність коморбідних станів [2].…”

“…Наявні докази вказують на роль розладів ендокринної системи в патогенезі хронічної патології легень (рис.). Зокрема, метаболічні супутні захворювання значно погіршують якість життя пацієнтів і підвищують смертність [1,4]. Найчастішими коморбідними розладами в пацієнтів із хронічними хворобами легень є цукровий діабет, дисліпідемія, остеопороз і хвороби щитоподібної залози (гіпо-та гіпертиреоз) [5][6][7][8].…”

Astımda sistemik komorbiditeler: Kontrol, ağırlık ve fenotip ile ilişkisi

“…Ayrıca komorbid hastalıkların hem astım kontrolünü zorlaştırdığı hem de yaşam kalitesini düşürdüğü düşünülmektedir (1). Solunum sisteminin bir diğer sık görülen hastalığı olan kronik obstrüktif akciğer hastalığı (KOAH)'nda komorbiditelerin önemi vurgulanmışken astım ve komorbidite ilişkisi halen üzerinde yeterli araştırma yapılmamış bir alan olarak karşımıza çıkmaktadır (2).…”