Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease

Camiciottoli, Gianna; Bigazzi, Francesca; Magni, Chiara; Bonti, Viola; Diciotti, Stefano; Bartolucci, Maurizio; Mascalchi, Mario; Pistolesi, Massimo

doi:10.2147/copd.s111724

Cited by 49 publications

(35 citation statements)

References 39 publications

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“…COPD was associated with other diseases in up to 80% of the patients in our series, the most common comorbidity being arterial hypertension; these data coincide with the findings of most previously published studies 40,41. When comorbidities were analyzed according to the use of tobacco, it was found that patients with osteoporosis were more likely to be active smokers.…”

Section: Discussionsupporting

confidence: 91%

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Riesco¹,

Alcázar²,

Trigueros³

et al. 2017

COPD

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PurposeSmoking can affect both the phenotypic expression of COPD and factors such as disease severity, quality of life, and comorbidities. Our objective was to evaluate if the impact of active smoking on these factors varies according to the disease phenotype.Patients and methodsThis was a Spanish, observational, cross-sectional, multicenter study of patients with a diagnosis of COPD. Smoking rates were described among four different phenotypes (non-exacerbators, asthma-COPD overlap syndrome [ACOS], exacerbators with emphysema, and exacerbators with chronic bronchitis), and correlated with disease severity (body mass index, obstruction, dyspnea and exacerbations [BODEx] index and dyspnea grade), quality of life according to the COPD assessment test (CAT), and presence of comorbidities, according to phenotypic expression.ResultsIn total, 1,610 patients were recruited, of whom 46.70% were classified as non-exacerbators, 14.53% as ACOS, 16.37% as exacerbators with emphysema, and 22.40% as exacerbators with chronic bronchitis. Smokers were predominant in the latter 2 groups (58.91% and 57.67%, respectively, P=0.03). Active smoking was significantly associated with better quality of life and a higher dyspnea grade, although differences were observed depending on clinical phenotype.ConclusionActive smoking is more common among exacerbator phenotypes and appears to affect quality of life and dyspnea grade differently, depending on the clinical expression of the disease.

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Section: Discussionsupporting

confidence: 91%

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Riesco¹,

Alcázar²,

Trigueros³

et al. 2017

COPD

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“…Recent work by Camiciottoli et al 35 described different panels of comorbidities among patients with predominant chronic bronchitis phenotype versus patients with emphysema. It is possible frailty may be more common in certain phenotypes and the mechanisms driving the presence of frailty within a diagnosis may vary.…”

Section: Discussionmentioning

confidence: 99%

Frailty and maximal exercise capacity in adult lung transplant candidates

Layton

Armstrong

Baldwin

et al. 2017

Respiratory Medicine

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Background Frail lung transplant candidates are more likely to be delisted or die without receiving a transplant. Further knowledge of what frailty represents in this population will assist in developing interventions to prevent frailty from developing. We set out to determine whether frail lung transplant candidates have reduced exercise capacity independent of disease severity and diagnosis. Methods Sixty-eight adult lung transplant candidates underwent cardiopulmonary exercise testing (CPET) and a frailty assessment (Fried’s Frailty Phenotype (FFP)). Primary outcomes were peak workload and peak aerobic capacity ( trueV˙normalO2). We used linear regression to adjust for age, gender, diagnosis, and lung allocation score (LAS). Results The mean ± SD age was 57 ± 11 years, 51% were women, 57% had interstitial lung disease, 32% had chronic obstructive pulmonary disease, 11% had cystic fibrosis, and the mean LAS was 40.2 (range 19.2 to 94.5). In adjusted models, peak workload decreased by 10 watts (95% CI 4.7 to 14.6) and peak trueV˙normalO2 decreased by 1.8 ml/kg/min (95% CI 0.6 to 2.9) per 1 unit increment in FFP score. After adjustment, exercise tolerance was 38 watts lower (95% CI 18.4 to 58.1) and peak trueV˙normalO2 was 8.5 ml/kg/min lower (95% CI 3.3 to 13.7) among frail participants compared to non-frail participants. Frailty accounted for 16% of the variance (R2) of watts and 19% of the variance of trueV˙normalO2 in adjusted models. Conclusion Frailty contributes to reduced exercise capacity among lung transplant candidates independent of disease severity.

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“…The dependent variable in the multivariate analysis was the diagnosis of the comorbidity. We selected as independent (explanatory) variables those variables with a previously reported association in the medical literature (age [17] , gender [5] , severity of COPD [5, Golpe et al , and clinical phenotype [6] ) or with biological plausibility of an association (frequent COPD exacerbations and the type of smoke exposure, which was the basis for the working hypothesis). Age was coded in 1-year increments.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, our study provides the opportunity to test the interactions between sex and other variables in B-COPD. Another strength is that, unlike some studies carried out using administrative databases, the diagnosis of COPD was objectively confirmed with lung function testing, and we were able to include explaining variables, such as severity of the ventilatory obstruction and the COPD phenotype, that in previous studies have been found to be associated with comorbidities [5,6] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Major Comorbidities in Chronic Obstructive Pulmonary Disease Caused by Biomass Smoke or Tobacco

Golpe

Martín-Robles²,

Sanjuán-López³

et al. 2017

Respiration

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Background: Comorbidities are very common in chronic obstructive pulmonary disease (COPD), contributing to the overall severity of the disease. The relative prevalence of comorbidities in COPD caused by biomass smoke (B-COPD), compared with COPD related to tobacco (T-COPD), is not well known. Objectives: To establish if both types of COPD are associated with a different risk for several major comorbidities. Method: The prevalence of comorbidities was compared in 863 subjects with B-COPD (n = 179, 20.7%) or T-COPD (n = 684, 79.2%). Multivariate analysis was carried out to explore the independent relationship between comorbidities and type of exposure. Results: Three comorbidities were more frequent in T-COPD than in B-COPD: ischemic heart disease (11.5 vs. 5.0%, respectively, p = 0.01), peripheral vascular disease (9.2 vs. 2.7%, p = 0.006), and peptic ulcer disease (4.8% vs. 0, p = 0.005). After correcting for potential confounding variables, the risk of ischemic heart disease was lower in B-COPD than in T-COPD (OR: 0.33, 95% CI: 0.16-0.69, p = 0.003). Conclusions: The prevalence of ischemic heart disease is significantly lower in B-COPD than in T-COPD, suggesting a different systemic effect of both types of smoke in COPD patients.

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Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease

Cited by 49 publications

References 39 publications

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Frailty and maximal exercise capacity in adult lung transplant candidates

Prevalence of Major Comorbidities in Chronic Obstructive Pulmonary Disease Caused by Biomass Smoke or Tobacco

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