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Mao X, Liang C, Niu H, Dong F, Huang K, Chen Y, Huang K, Zhan Q, Zhang Y, Huang Y, Yang T, Wang C. Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry. Respir Res 2021; 22:7. [PMID: 33407433 PMCID: PMC7789818 DOI: 10.1186/s12931-020-01607-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/17/2020] [Indexed: 01/01/2023] Open
Abstract
Background Diabetes is a common comorbidity among patients with exacerbation of chronic obstructive pulmonary disease (AECOPD). Diabetes has been reported to be associated with length of stay (LOS), death, and cost among AECOPD patients. However, most studies are retrospective or have small sample sizes. The association for cost has not been researched using diabetes as a main analytic factor. This study aimed to fill gaps mentioned above, to compare basic characteristics between the diabetic and non-diabetic group, and to detect associations between diabetes and clinical outcomes among patients hospitalized with AECOPD. Methods A total of 5334 AECOPD patients, classified into diabetic and non-diabetic group, were included from a prospective multicenter patient registry study. Generalized linear regression and logistic regression were separately used for the association between diabetes and direct hospitalization cost and the association between diabetes and LOS. Results Generally, diabetic patients had a more severe profile, including being older, more overweight or obese, having more former smokers, more emergency room visits in the past 12 months, and more comorbidities occurrence. Diabetic patients also had worse clinical outcomes, including higher cost and longer LOS. Additionally, the generalized linear regression indicated that the marginal mean cost difference between diabetic and non-diabetic patients was RMB (¥) 775.7. Conclusions AECOPD patients with comorbid diabetes had a more severe profile and higher direct hospitalization cost. Diabetes screening and integrated care programs might help reduce the heavy comorbidity and economic burden. Moreover, corticosteroids and metformin could be considered in the treatment of these patients. Trial registration Clinicaltrials.gov with the identifier NCT0265752.
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Affiliation(s)
- Xihua Mao
- Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China
| | - Chen Liang
- Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China
| | - Hongtao Niu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China
| | - Fen Dong
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China.,Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Kewu Huang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Qingyuan Zhan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China
| | - Yaowen Zhang
- Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China
| | - Yin Huang
- Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China. .,National Clinical Research Center for Respiratory Diseases, Beijing, China. .,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China.
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China. .,National Clinical Research Center for Respiratory Diseases, Beijing, China. .,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China. .,Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng, Beijing, 100730, China.
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Machón M, Mosquera I, Larrañaga I, Martín U, Vergara I. [Socioeconomic inequalities in health among the elderly population in Spain]. GACETA SANITARIA 2020; 34:276-288. [PMID: 31563284 DOI: 10.1016/j.gaceta.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine socioeconomic inequalities in health in the older population in Spain. METHOD A systematic search and review of the literature published between 2000 and 2017 in English and Spanish was conducted in Social Science Citation Index, Sociology Database, Scopus, PubMed and Embase. Primary and secondary studies analysing these inequalities in Spain were included. Two researchers were responsible for the selection of the studies and the extraction of the information (first author, year of publication, region, design, population/sample, socioeconomic and health indicators used, and main results). RESULTS A total of 89 articles were included, corresponding to 87 studies. Of the studies, 81.6% were cross-sectional, 88.5% included only non-institutionalised population and 35.6% were carried out at a national level. The studies analysed social inequalities in the following health indicators: functional status (n=29), morbidity (n=19), self-perceived health (n=18), mental and emotional health (n=10), cognitive status (n=7), quality of life (n=9), mortality (n=15) and life expectancy (n=2). Socioeconomic inequalities were detected in all of them, although the magnitude varied depending on the socioeconomic and health indicator used. The educational level and the ecological indexes were the indicators that detected more inequalities in health. The impact of inequalities by sex was different in functional status, morbidity, self-perceived health, mental and emotional health and mortality. CONCLUSION There are socioeconomic inequalities in health among the elderly population and their magnitude varies by sex in some of the health indicators. The increase in educational level and the maintenance of sufficient pensions can be key policies that contribute to the reduction of inequalities in this population group.
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Affiliation(s)
- Mónica Machón
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España.
| | - Isabel Larrañaga
- Departamento de Salud, Delegación Territorial de Gipuzkoa, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
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Mosquera I, Machón M, Vergara I, Larrañaga I, Martín U. [Social inequalities in health among the elderly population: review of indicators used in Spain]. GACETA SANITARIA 2019; 34:297-304. [PMID: 30665691 DOI: 10.1016/j.gaceta.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain. METHOD A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature. RESULTS We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n=73). Other individual variables used were occupation (n=17), objective economic level (n=16), subjective economic level (n=4), housing and household material wealth (n=6), relationship with work activity (n=5), and mixed measures (n=5). Among the ecological indicators, simple (n=3) and complex indices (n=7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described. CONCLUSIONS A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research.
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Affiliation(s)
- Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
| | - Mónica Machón
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España.
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Larrañaga
- Departamento de Salud, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
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Miravitlles M, Price D, Rabe KF, Schmidt H, Metzdorf N, Celli B. Comorbidities of patients in tiotropium clinical trials: comparison with observational studies of patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10:549-64. [PMID: 25834416 PMCID: PMC4365745 DOI: 10.2147/copd.s71913] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is an ongoing debate on whether patients with chronic obstructive pulmonary disease (COPD) seen in real-life clinical settings are represented in randomized controlled trials (RCTs) of COPD. It is thought that the stringent inclusion and exclusion criteria of RCTs may prevent the participation of patients with specific characteristics or risk factors. METHODS We surveyed a database of patients recruited into 35 placebo-controlled tiotropium RCTs and also conducted a systematic literature review of large-scale observational studies conducted in patients with a documented diagnosis of COPD between 1990 and 2013. Patient demographics and comorbidities with a high prevalence in patients with COPD were compared between the two patient populations at baseline. Using the Medical Dictionary for Regulatory Activities (MedDRA; v 14.0), patient comorbidities in the pooled tiotropium RCTs were classified according to system organ class, pharmacovigilance (PV) endpoints, and Standardised MedDRA Queries to enable comparison with the observational studies. RESULTS We identified 24,555 patients in the pooled tiotropium RCTs and 61,361 patients among the 13 observational studies that met our search criteria. The Global initiative for chronic Obstructive Lung Disease (GOLD) staging of patients in the RCTs differed from that in observational studies: the proportion of patients with GOLD stages I+II disease ranged from 40.0% to 51.5% in the RCTs but 24.5% to 44.1% in the observational studies; for GOLD stage III or IV disease these ranges were 7.2%-45.8% (RCTs) and 13.7-42.1% (observational studies). The comorbidities with the highest prevalence reported in the RCTs and observational studies were: hypertension (39.4%-40.0% vs 40.1%-60.6%), other ischemic heart disease (12.3%-14.2% vs 12.5%-41.0%), diabetes (10.3%-10.9% vs 4.0%-38.9%), depression (8.5%-9.5% vs 17.0%-20.6%), and cardiac arrhythmia (7.8%-11.4% vs 11.3%-15.8%). CONCLUSION The clinical profile of COPD patients treated in the tiotropium trial program appears to be largely in the range of clinical characteristics, including cardiovascular comorbidities, reported for "real-life patients." The tiotropium RCTs tended to include patients with more severe disease than the observational studies.
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Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - David Price
- Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Klaus F Rabe
- Department of Medicine, Christian-Albrechts-Universität zu Kiel (CAU), Großhansdorf, Germany ; LungenClinic Grosshansdorf, Großhansdorf, Germany
| | - Hendrik Schmidt
- Global Biometrics and Clinical Applications, Boehringer Ingelheim Pharma GmbH and Co KG, Ingelheim am Rhein, Germany
| | - Norbert Metzdorf
- TA Respiratory Diseases, Boehringer Ingelheim Pharma GmbH and Co KG, Ingelheim am Rhein, Germany
| | - Bartolome Celli
- Pulmonary Division, Brigham and Women's Hospital, Boston, MA, USA
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Putcha N, Han MK, Martinez CH, Foreman MG, Anzueto AR, Casaburi R, Cho MH, Hanania NA, Hersh CP, Kinney GL, Make BJ, Steiner RM, Lutz SM, Thomashow BM, Williams AA, Bhatt SP, Beaty TH, Bowler RP, Ramsdell JW, Curtis JL, Everett D, Hokanson JE, Lynch DA, Sutherland ER, Silverman EK, Crapo JD, Wise RA, Regan EA, Hansel NN. Comorbidities of COPD have a major impact on clinical outcomes, particularly in African Americans. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2015; 1:105-114. [PMID: 25695106 PMCID: PMC4329763 DOI: 10.15326/jcopdf.1.1.2014.0112] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND COPD patients have a great burden of comorbidity. However, it is not well established whether this is due to shared risk factors such as smoking, if they impact patients exercise capacity and quality of life, or whether there are racial disparities in their impact on COPD. METHODS We analyzed data from 10,192 current and ex-smokers with (cases) and without COPD (controls) from the COPDGene® cohort to establish risk for COPD comorbidities adjusted for pertinent covariates. In adjusted models, we examined comorbidities prevalence and impact in African-Americans (AA) and Non-Hispanic Whites (NHW). RESULTS Comorbidities are more common in COPD compared to those with normal spirometry (controls), and the risk persists after adjustments for covariates including pack-years smoked. After adjustment for confounders, eight conditions were independently associated with worse exercise capacity, quality of life and dyspnea. There were racial disparities in the impact of comorbidities on exercise capacity, dyspnea and quality of life, presence of osteoarthritis and gastroesophageal reflux disease having a greater negative impact on all three outcomes in AAs than NHWs (p<0.05 for all interaction terms). CONCLUSIONS Individuals with COPD have a higher risk for comorbidities than controls, an important finding shown for the first time comprehensively after accounting for confounders. Individual comorbidities are associated with worse exercise capacity, quality of life, and dyspnea, in African-Americans compared to non-Hispanic Whites.
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Affiliation(s)
- Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Meilan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Carlos H Martinez
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Marilyn G Foreman
- Divison of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Antonio R Anzueto
- Pulmonary Section, Department of Medicine, University of Texas Health Science Center, and South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicola A Hanania
- Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Craig P Hersh
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Barry J Make
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, USA
| | - Robert M Steiner
- Department of Radiology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sharon M Lutz
- Colorado School of Public Health, Aurora, Colorado, USA
| | - Byron M Thomashow
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University, New York, New York, USA
| | - Andre A Williams
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | - Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA
| | - Terri H Beaty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, USA
| | - Joe W Ramsdell
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas Everett
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | | | - David A Lynch
- Division of Radiology, National Jewish Health, Denver, Colorado, USA
| | - E Rand Sutherland
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, USA
| | - Edwin K Silverman
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James D Crapo
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, USA
| | - Robert A Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth A Regan
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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de Ornelas Maia ACC, Braga ADA, Paes F, Machado S, Carta MG, Nardi AE, Silva AC. Comorbidity of depression and anxiety: association with poor quality of life in type 1 and 2 diabetic patients. Clin Pract Epidemiol Ment Health 2013; 9:136-41. [PMID: 23935696 PMCID: PMC3735923 DOI: 10.2174/1745017901309010136] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 05/18/2013] [Accepted: 05/19/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes is associates with depression and impairment in Quality of Life (QoL). OBJECTIVE The objective is to define the frequencies of depressive and anxiety symptoms in a sample of patients diagnosed with type 1 and 2 diabetes, the amount of impairment of QoL and the weight of depression and anxiety in determining the QoL in such of patients. METHODS A total of 210 patients were divided into two groups (type 1 and type 2). Patients completed the HADS and WHOQoL-bref. RESULTS Groups showed a high prevalence of anxiety (type 1 = 60%, type 2 = 43.8%) and depression (type 1 = 52.4%, type 2 = 38.1%), both measures were significantly higher (p < 0.05) in diabetes type 1 patients. Type 1 patients also showed a QoL in the overall assessment and the physical, psychological and social relations domains. In both Type 1 and 2 diabetes poor QoL was found associated by anxiety and depression comorbidity. CONCLUSION In overall diabetes patients depression and anxiety seems to be a determinant of poor QoL.
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Affiliation(s)
- Ana Claudia C de Ornelas Maia
- Laboratory of Panic and Respiration -Institute of Psychiatry of Federal University of Rio de Janeiro, Rio de Janeiro - Brazil, National Institute of Translational Medicine (INCT-TM), Brazil
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Janson C, Marks G, Buist S, Gnatiuc L, Gislason T, McBurnie MA, Nielsen R, Studnicka M, Toelle B, Benediktsdottir B, Burney P. The impact of COPD on health status: findings from the BOLD study. Eur Respir J 2013; 42:1472-83. [PMID: 23722617 PMCID: PMC3844139 DOI: 10.1183/09031936.00153712] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this study was to describe the impact of chronic obstructive pulmonary disease (COPD) on health status in the Burden of Obstructive Lung Disease (BOLD) populations. We conducted a cross-sectional, general population-based survey in 11 985 subjects from 17 countries. We measured spirometric lung function and assessed health status using the Short Form 12 questionnaire. The physical and mental health component scores were calculated. Subjects with COPD (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <0.70, n = 2269) had lower physical component scores (44±10 versus 48±10 units, p<0.0001) and mental health component scores (51±10 versus 52±10 units, p = 0.005) than subjects without COPD. The effect of reported heart disease, hypertension and diabetes on physical health component scores (-3 to -4 units) was considerably less than the effect of COPD Global Initiative for Chronic Obstructive Lung Disease grade 3 (-8 units) or 4 (-11 units). Dyspnoea was the most important determinant of a low physical and mental health component scores. In addition, lower forced expiratory volume in 1 s, chronic cough, chronic phlegm and the presence of comorbidities were all associated with a lower physical health component score. COPD is associated with poorer health status but the effect is stronger on the physical than the mental aspects of health status. Severe COPD has a greater negative impact on health status than self-reported cardiovascular disease and diabetes. COPD is related to worse health status: impairment is greater than in self-reported cardiovascular diseases or diabeteshttp://ow.ly/p1cIx
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Affiliation(s)
- Christer Janson
- Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
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Hackman KL, Snell GI, Bach LA. An unexpectedly high prevalence of undiagnosed diabetes in patients awaiting lung transplantation. J Heart Lung Transplant 2013; 32:86-91. [DOI: 10.1016/j.healun.2012.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 10/08/2012] [Accepted: 10/17/2012] [Indexed: 11/29/2022] Open
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Sundh J, Ställberg B, Lisspers K, Montgomery SM, Janson C. Co-morbidity, body mass index and quality of life in COPD using the Clinical COPD Questionnaire. COPD 2011; 8:173-81. [PMID: 21513436 DOI: 10.3109/15412555.2011.560130] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Quality of life is an important patient-oriented measure in COPD. The Clinical COPD Questionnaire (CCQ) is a validated instrument for estimating quality of life. The impact of different factors on the CCQ-score remains an understudied area. The aim of this study was to investigate the association of co-morbidity and body mass index with quality of life measured by CCQ. METHODS A patient questionnaire including the CCQ and a review of records were used. A total of 1548 COPD patients in central Sweden were randomly selected. Complete data were collected for 919 patients, 639 from primary health care and 280 from hospital clinics. Multiple linear regression with adjustment for sex, age, level of education, smoking habits and level of care was performed. Subanalyses included additional adjustment for lung function in the subgroup (n = 475) where spirometry data were available. RESULTS Higher mean CCQ score indicating lower quality of life was statistically significant and independently associated with heart disease (adjusted regression coefficient (95%CI) 0.26; 0.06 to 0.47), depression (0.50; 0.23 to 0.76) and underweight (0.58; 0.29 to 0.87). Depression and underweight were associated with higher scores in all CCQ subdomains. Further adjustment for lung function in the subgroup with this measure resulted in statistically significant and independent associations with CCQ for heart disease, depression, obesity and underweight. CONCLUSION The CCQ identified that heart disease, depression and underweight are independently associated with lower health-related quality of life in COPD.
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Affiliation(s)
- Josefin Sundh
- Department of Respiratory Medicine, Örebro University Hospital, 701 85 Örebro, Sweden.
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Macario CC, Torres Tajes JPD, Lanus EC. EPOC: inflamación bronquial y sistémica. Arch Bronconeumol 2010; 46 Suppl 4:9-15. [DOI: 10.1016/s0300-2896(10)70027-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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