Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients
Suk Hyeon Jeong,1,* Hyun Lee,1,* KC Carriere,2,3 Sun Hye Shin,1 Seong Mi Moon,1 Byeong-Ho Jeong,1 Won-Jung Koh,1 Hye Yun Park1 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; 2Departme...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-08-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/comorbidity-as-a-contributor-to-frequent-severe-acute-exacerbation-in--peer-reviewed-article-COPD |
| _version_ | 1819009265420992512 |
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| author | Jeong SH Lee H Carriere KC Shin SH Moon SM Jeong BH Koh WJ Park HY |
| author_facet | Jeong SH Lee H Carriere KC Shin SH Moon SM Jeong BH Koh WJ Park HY |
| author_sort | Jeong SH |
| collection | DOAJ |
| description | Suk Hyeon Jeong,1,* Hyun Lee,1,* KC Carriere,2,3 Sun Hye Shin,1 Seong Mi Moon,1 Byeong-Ho Jeong,1 Won-Jung Koh,1 Hye Yun Park1 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; 2Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada; 3Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, South Korea *These authors contributed equally to this work Background: Comorbidities have a serious impact on the frequent severe acute exacerbations (AEs) in patients with COPD. Previous studies have used the Charlson comorbidity index to represent a conglomerate of comorbidities; however, the respective contribution of each coexisting disease to the frequent severe AEs remains unclear.Methods: A retrospective, observational study was performed in 77 COPD patients who experienced severe AE between January 2012 and December 2014 and had at least 1-year follow-up period from the date of admission for severe AE. We explored the incidence of frequent severe AEs (≥2 severe AEs during 1-year period) in these patients and investigated COPD-related factors and comorbidities as potential risk factors of these exacerbations.Results: Out of 77 patients, 61 patients (79.2%) had at least one comorbidity. During a 1-year follow-up period, 29 patients (37.7%) experienced frequent severe AEs, approximately two-thirds (n=19) of which occurred within the first 90 days after admission. Compared with patients not experiencing frequent severe AEs, these patients were more likely to have poor lung function and receive home oxygen therapy and long-term oral steroids. In multiple logistic regression analysis, coexisting asthma (adjusted odds ratio [OR] =4.02, 95% confidence interval [CI] =1.30–12.46, P=0.016), home oxygen therapy (adjusted OR =9.39, 95% CI =1.60–55.30, P=0.013), and C-reactive protein (adjusted OR =1.09, 95% CI =1.01–1.19, P=0.036) were associated with frequent severe AEs. In addition, poor lung function, as measured by forced expiratory volume in 1 second (adjusted OR =0.16, 95% CI =0.04–0.70, P=0.015), was inversely associated with early (ie, within 90 days of admission) frequent severe AEs.Conclusion: Based on our study, among COPD-related comorbidities, coexisting asthma has a significant impact on the frequent severe AEs in COPD patients. Keywords: asthma, chronic obstructive pulmonary disease, comorbidity, exacerbation |
| first_indexed | 2024-12-21T00:53:37Z |
| format | Article |
| id | doaj.art-79d35e5870ec4e4a9dabbc064e02769d |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-21T00:53:37Z |
| publishDate | 2016-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-79d35e5870ec4e4a9dabbc064e02769d2022-12-21T19:21:20ZengDove Medical PressInternational Journal of COPD1178-20052016-08-012016Issue 11857186528257Comorbidity as a contributor to frequent severe acute exacerbation in COPD patientsJeong SHLee HCarriere KCShin SHMoon SMJeong BHKoh WJPark HYSuk Hyeon Jeong,1,* Hyun Lee,1,* KC Carriere,2,3 Sun Hye Shin,1 Seong Mi Moon,1 Byeong-Ho Jeong,1 Won-Jung Koh,1 Hye Yun Park1 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; 2Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada; 3Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, South Korea *These authors contributed equally to this work Background: Comorbidities have a serious impact on the frequent severe acute exacerbations (AEs) in patients with COPD. Previous studies have used the Charlson comorbidity index to represent a conglomerate of comorbidities; however, the respective contribution of each coexisting disease to the frequent severe AEs remains unclear.Methods: A retrospective, observational study was performed in 77 COPD patients who experienced severe AE between January 2012 and December 2014 and had at least 1-year follow-up period from the date of admission for severe AE. We explored the incidence of frequent severe AEs (≥2 severe AEs during 1-year period) in these patients and investigated COPD-related factors and comorbidities as potential risk factors of these exacerbations.Results: Out of 77 patients, 61 patients (79.2%) had at least one comorbidity. During a 1-year follow-up period, 29 patients (37.7%) experienced frequent severe AEs, approximately two-thirds (n=19) of which occurred within the first 90 days after admission. Compared with patients not experiencing frequent severe AEs, these patients were more likely to have poor lung function and receive home oxygen therapy and long-term oral steroids. In multiple logistic regression analysis, coexisting asthma (adjusted odds ratio [OR] =4.02, 95% confidence interval [CI] =1.30–12.46, P=0.016), home oxygen therapy (adjusted OR =9.39, 95% CI =1.60–55.30, P=0.013), and C-reactive protein (adjusted OR =1.09, 95% CI =1.01–1.19, P=0.036) were associated with frequent severe AEs. In addition, poor lung function, as measured by forced expiratory volume in 1 second (adjusted OR =0.16, 95% CI =0.04–0.70, P=0.015), was inversely associated with early (ie, within 90 days of admission) frequent severe AEs.Conclusion: Based on our study, among COPD-related comorbidities, coexisting asthma has a significant impact on the frequent severe AEs in COPD patients. Keywords: asthma, chronic obstructive pulmonary disease, comorbidity, exacerbationhttps://www.dovepress.com/comorbidity-as-a-contributor-to-frequent-severe-acute-exacerbation-in--peer-reviewed-article-COPDAsthmachronic obstructive pulmonary diseasecomorbidityexacerbation. |
| spellingShingle | Jeong SH Lee H Carriere KC Shin SH Moon SM Jeong BH Koh WJ Park HY Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients International Journal of COPD Asthma chronic obstructive pulmonary disease comorbidity exacerbation. |
| title | Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients |
| title_full | Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients |
| title_fullStr | Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients |
| title_full_unstemmed | Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients |
| title_short | Comorbidity as a contributor to frequent severe acute exacerbation in COPD patients |
| title_sort | comorbidity as a contributor to frequent severe acute exacerbation in copd patients |
| topic | Asthma chronic obstructive pulmonary disease comorbidity exacerbation. |
| url | https://www.dovepress.com/comorbidity-as-a-contributor-to-frequent-severe-acute-exacerbation-in--peer-reviewed-article-COPD |
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