The effect of comorbidities on COPD assessment: a pilot study

Weinreich, Ulla Møller; Thomsen, Lars Pilegaard; Bielaska, Barbara; Jensen, Vania Helbo; Vuust, Morten; Rees, Stephen Edward

doi:10.2147/copd.s76124

Cited by 10 publications

(10 citation statements)

References 39 publications

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“…The high impact of comorbidities is further emphasized by the evidence that two or more disorders were recorded in the vast majority of patients (68.8 %), and that three or more were also found in near 50 % of COPD subjects. These data confirm those of other recent studies focusing the same aspect in COPD [3,21,22]. Actually, the clinical relevance of these figures is also emphasized by the mean CCI value assessed in the present paper, which was higher than that found in other studies [23] (3.4 vs 2.5, respectively), thus contributing to support and explain the higher prevalence of comorbidities per patient found in our cohort of patients (i.e.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

2015

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Background: Several comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution. Methods: The study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012–2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file. Variables collected were: lung function; smoking history; BMI; the Charlson Comorbidity Index (CCI); number and kind of comorbidities for each patient. Results: At least one comorbidity of clinical relevance was found in 78.6 % of patients, but at least two in 68.8 %, and three or more were found in 47.9 % of subjects. Mean CCI was 3.4 ± 1.6sd. The overall prevalence was 2.6 comorbidities per patient, but 2.5 in males, and 3.0 in females, respectively (p < 0.05). Cardio-vascular disorders were the most frequent, but significantly more frequent in males (44.7 vs 30.7 %, respectively), while the metabolic, the digestive and the osteo-articular disorders were prevailing in females (12.4 vs 9.2; 14.2 vs 4.8, and 6.0 vs 3.8, respectively). In particular, chronic cor pumonale and arrhythmias mainly prevailed in men and congestive heart failure in females, while arterial hypertension resulted equally distributed. As concerning respiratory disorders, pneumonia, pleural effusions and chronic respiratory failure were more frequently found in men, while bronchiectasis and asthma-COPD overlap syndrome (ACOS) in females. Anaemia, gall bladder stones, osteoporosis and spontaneous fractures mostly prevailed in females, while gastric disorders of inflammatory origin and arthrosis were more frequent in males. Cognition disorders, dementia and signs of degenerative brain disorders were more frequently found in men, while depression in females. Finally, lung cancer was at the first place in men, but at the second in females. Conclusions: All comorbidities increased their prevalence progressively up to the last stage of COPD severity, except the cardio-vascular and the metabolic ones which dropped in the IV GOLD stage, presumably due to the high mortality rate in this severe COPD stage. The gender-dependency of comorbidities was confirmed in general terms, even if lung cancer proved a dramatic increase almost independently of sex.

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Section: Discussionsupporting

confidence: 93%

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

2015

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Section: Discussionsupporting

confidence: 92%

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

Negro

Bonadiman

Turco

2015

Multidiscip Respir Med

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BackgroundSeveral comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution.MethodsThe study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012–2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file. Variables collected were: lung function; smoking history; BMI; the Charlson Comorbidity Index (CCI); number and kind of comorbidities for each patient.ResultsAt least one comorbidity of clinical relevance was found in 78.6 % of patients, but at least two in 68.8 %, and three or more were found in 47.9 % of subjects. Mean CCI was 3.4 ± 1.6sd. The overall prevalence was 2.6 comorbidities per patient, but 2.5 in males, and 3.0 in females, respectively (p < 0.05). Cardio-vascular disorders were the most frequent, but significantly more frequent in males (44.7 vs 30.7 %, respectively), while the metabolic, the digestive and the osteo-articular disorders were prevailing in females (12.4 vs 9.2; 14.2 vs 4.8, and 6.0 vs 3.8, respectively). In particular, chronic cor pumonale and arrhythmias mainly prevailed in men and congestive heart failure in females, while arterial hypertension resulted equally distributed. As concerning respiratory disorders, pneumonia, pleural effusions and chronic respiratory failure were more frequently found in men, while bronchiectasis and asthma-COPD overlap syndrome (ACOS) in females. Anaemia, gall bladder stones, osteoporosis and spontaneous fractures mostly prevailed in females, while gastric disorders of inflammatory origin and arthrosis were more frequent in males. Cognition disorders, dementia and signs of degenerative brain disorders were more frequently found in men, while depression in females. Finally, lung cancer was at the first place in men, but at the second in females.ConclusionsAll comorbidities increased their prevalence progressively up to the last stage of COPD severity, except the cardio-vascular and the metabolic ones which dropped in the IV GOLD stage, presumably due to the high mortality rate in this severe COPD stage. The gender-dependency of comorbidities was confirmed in general terms, even if lung cancer proved a dramatic increase almost independently of sex.

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“…The validity of the COTE has been questioned since patients with GOLD B seem to have worse survival than patients with GOLD C, because of the particular heart disease found in a very large population study in Copenhagen area [ 5 ]. Some authors suggest that the presence of comorbidities should influence the relationship between the GOLD score and lung function measurements, the former perhaps being more representative of morbidity than of COPD severity [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Comorbidities and COPD severity in a clinic-based cohort

et al. 2018

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BackgroundChronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality around the world. The aim of our study was to determine the association between specific comorbidities and COPD severity.MethodsPulmonologists included patients with COPD using a web-site questionnaire. Diagnosis of COPD was made using spirometry post-bronchodilator FEV1/FVC < 70%. The questionnaire included the following domains: demographic criteria, clinical symptoms, functional tests, comorbidities and therapeutic management. COPD severity was classified according to GOLD 2011. First we performed a principal component analysis and a non-hierarchical cluster analysis to describe the cluster of comorbidities.ResultsOne thousand, five hundred and eighty-four patients were included in the cohort during the first 2 years. The distribution of COPD severity was: 27.4% in group A, 24.7% in group B, 11.2% in group C, and 36.6% in group D. The mean age was 66.5 (sd: 11), with 35% of women. Management of COPD differed according to the comorbidities, with the same level of severity. Only 28.4% of patients had no comorbidities associated with COPD. The proportion of patients with two comorbidities was significantly higher (p < 0.001) in GOLD B (50.4%) and D patients (53.1%) than in GOLD A (35.4%) and GOLD C ones (34.3%). The cluster analysis showed five phenotypes of comorbidities: cluster 1 included cardiac profile; cluster 2 included less comorbidities; cluster 3 included metabolic syndrome, apnea and anxiety-depression; cluster 4 included denutrition and osteoporosis and cluster 5 included bronchiectasis. The clusters were mostly significantly associated with symptomatic patients i.e. GOLD B and GOLD D.ConclusionsThis study in a large real-life cohort shows that multimorbidity is common in patients with COPD.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0684-7) contains supplementary material, which is available to authorized users.

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The effect of comorbidities on COPD assessment: a pilot study

Cited by 10 publications

References 39 publications

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

Prevalence of different comorbidities in COPD patients by gender and GOLD stage

Comorbidities and COPD severity in a clinic-based cohort

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