M-A Kim1, C S Noh2, Y-J Chang3, Y-K Hong4, J S Lee5, S W Lee5, S-D Lee5, Y-M Oh5. 1. Department of Allergy and Clinical Immunology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea. 2. Department of Internal Medicine, Seoul Seonam Hospital, Ewha Womans University Medical Center, Seoul, Republic of Korea. 3. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea. 4. Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea. 5. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with poor prognosis and a high health care burden. The incidence of asthma and COPD overlap syndrome is increasing, and contributes to a high financial burden and poor prognosis. OBJECTIVE: To investigate clinical features of the overlap syndrome among Asian patients and to analyse its impact on hospitalisation due to respiratory problems or death compared to COPD alone. DESIGN: We performed a retrospective cohort analysis of 2933 COPD patients presenting at the Asan Medical Center from 1 January 2000 to 31 December 2009. Kaplan-Meier and Cox proportional hazard models were used to analyse the significance of clinical parameters, including age, sex, smoking history, body mass index (BMI), severity of airflow limitation, airway obstruction reversibility and overlap syndrome with hospitalisation due to respiratory problems or death. RESULTS: Overlap syndrome patients were older, included smaller proportions of males and of smokers and had lower forced expiratory volume in 1 s (FEV1) (% predicted). Shorter hospitalisation-free and survival periods were noted among overlap syndrome patients. Overlap syndrome was significantly associated with risk of hospitalisation due to respiratory problems after adjusting for age, smoking history, BMI, FEV1 (% predicted) and changes in FEV1 (P < 0.001). CONCLUSION: Asthma and COPD overlap syndrome is associated with a higher risk of hospitalisation due to respiratory problems than COPD alone.
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is associated with poor prognosis and a high health care burden. The incidence of asthma and COPD overlap syndrome is increasing, and contributes to a high financial burden and poor prognosis. OBJECTIVE: To investigate clinical features of the overlap syndrome among Asian patients and to analyse its impact on hospitalisation due to respiratory problems or death compared to COPD alone. DESIGN: We performed a retrospective cohort analysis of 2933 COPDpatients presenting at the Asan Medical Center from 1 January 2000 to 31 December 2009. Kaplan-Meier and Cox proportional hazard models were used to analyse the significance of clinical parameters, including age, sex, smoking history, body mass index (BMI), severity of airflow limitation, airway obstruction reversibility and overlap syndrome with hospitalisation due to respiratory problems or death. RESULTS:Overlap syndromepatients were older, included smaller proportions of males and of smokers and had lower forced expiratory volume in 1 s (FEV1) (% predicted). Shorter hospitalisation-free and survival periods were noted among overlap syndromepatients. Overlap syndrome was significantly associated with risk of hospitalisation due to respiratory problems after adjusting for age, smoking history, BMI, FEV1 (% predicted) and changes in FEV1 (P < 0.001). CONCLUSION:Asthma and COPD overlap syndrome is associated with a higher risk of hospitalisation due to respiratory problems than COPD alone.
Authors: Nirupama Putcha; Ashraf Fawzy; Elizabeth C Matsui; Mark C Liu; Russ P Bowler; Prescott G Woodruff; Wanda K O'Neal; Alejandro P Comellas; MeiLan K Han; Mark T Dransfield; J Michael Wells; Njira Lugogo; Li Gao; C Conover Talbot; Eric A Hoffman; Christopher B Cooper; Laura M Paulin; Richard E Kanner; Gerard Criner; Victor E Ortega; R Graham Barr; Jerry A Krishnan; Fernando J Martinez; M Bradley Drummond; Robert A Wise; Gregory B Diette; Craig P Hersh; Nadia N Hansel Journal: Chest Date: 2020-05-23 Impact factor: 10.262