V Areias1, S Carreira2, M Anciães2, P Pinto3, C Bárbara4. 1. Serviço de Pneumologia, Hospital de Faro, Faro, Portugal. Electronic address: vandareias@hotmail.com. 2. Serviço de Pneumologia II, Centro Hospitalar Lisboa Norte, Hospital Pulido Valente, Lisboa, Portugal. 3. Serviço de Pneumologia II, Centro Hospitalar Lisboa Norte, Hospital Pulido Valente, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. 4. Serviço de Pneumologia I e II, Centro Hospitalar Lisboa Norte, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Abstract
INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is associated with several co-morbidities, however their prevalence varies from one study to another. AIM: To determine the prevalence of several co-morbidities in patients with COPD severity score GOLD 4 (The Global Initiative for Chronic Obstructive Lung Disease, 2010) followed in ambulatory care, in a University Hospital. METHODS: A questionnaire was designed and carried out in order to characterize COPD and its co-morbidities. Clinical files were consulted in order to complete the data. RESULTS: 89 patients (87% male) with a mean age of 68 years old, of which 79% were ex-smokers, were included. The average value of FEV1 (forced expiratory volume in one second) was 38% of the expected values and all the patients presented chronic respiratory failure. Thirty-five patients (39%) were frequent exacerbators. Thirty-seven patients (42%) had been hospitalized at least once due to exacerbation of their respiratory disease in the previous year, and 66 patients (74%) hospitalized in the previous five years. Most of the patients (97%) presented at least one comorbidity, with an average of 4 co-morbidities per patient and an average Charlson index of 2. The most frequent co-morbidities were cardiovascular diseases (69%), osteoarticular pathology (51%), erectile dysfunction (48%), sleep apnoea syndrome (43%) dyslipidaemia (35%), cataracts (31%), gastroesophageal reflux (29%) and diabetes (20%). Frequent exacerbators presented an increased risk of having two or more co-morbidities (Odds Ratio of 5), as well as a higher prevalence of gastroesophageal reflux (p=0.0006) and more hospitalizations in the last year and in the previous 5 years (p <0.001). CONCLUSION: This study confirmed the high prevalence and the association of co-morbidities in patients with COPD severity score GOLD 4, thus justifying the need for a comprehensive and integrating therapeutic approach.
INTRODUCTION:Chronic Obstructive Pulmonary Disease (COPD) is associated with several co-morbidities, however their prevalence varies from one study to another. AIM: To determine the prevalence of several co-morbidities in patients with COPD severity score GOLD 4 (The Global Initiative for Chronic Obstructive Lung Disease, 2010) followed in ambulatory care, in a University Hospital. METHODS: A questionnaire was designed and carried out in order to characterize COPD and its co-morbidities. Clinical files were consulted in order to complete the data. RESULTS: 89 patients (87% male) with a mean age of 68 years old, of which 79% were ex-smokers, were included. The average value of FEV1 (forced expiratory volume in one second) was 38% of the expected values and all the patients presented chronic respiratory failure. Thirty-five patients (39%) were frequent exacerbators. Thirty-seven patients (42%) had been hospitalized at least once due to exacerbation of their respiratory disease in the previous year, and 66 patients (74%) hospitalized in the previous five years. Most of the patients (97%) presented at least one comorbidity, with an average of 4 co-morbidities per patient and an average Charlson index of 2. The most frequent co-morbidities were cardiovascular diseases (69%), osteoarticular pathology (51%), erectile dysfunction (48%), sleep apnoea syndrome (43%) dyslipidaemia (35%), cataracts (31%), gastroesophageal reflux (29%) and diabetes (20%). Frequent exacerbators presented an increased risk of having two or more co-morbidities (Odds Ratio of 5), as well as a higher prevalence of gastroesophageal reflux (p=0.0006) and more hospitalizations in the last year and in the previous 5 years (p <0.001). CONCLUSION: This study confirmed the high prevalence and the association of co-morbidities in patients with COPD severity score GOLD 4, thus justifying the need for a comprehensive and integrating therapeutic approach.
Authors: David Gomez-Cabrero; Jörg Menche; Isaac Cano; Imad Abugessaisa; Mercedes Huertas-Migueláñez; Akos Tenyi; Igor Marin de Mas; Narsis A Kiani; Francesco Marabita; Francesco Falciani; Kelly Burrowes; Dieter Maier; Peter Wagner; Vitaly Selivanov; Marta Cascante; Josep Roca; Albert-László Barabási; Jesper Tegnér Journal: J Transl Med Date: 2014-11-28 Impact factor: 5.531