在初级保健环境中，心脏病对 COPD 的特征、生活质量、卫生资源利用和成本的影响。
The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings.
机构信息
Department of Pneumology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
出版信息
BMC Cardiovasc Disord. 2010 Feb 18;10:8. doi: 10.1186/1471-2261-10-8.
BACKGROUND
To evaluate the influence of heart disease on clinical characteristics, quality of life, use of health resources, and costs of patients with COPD followed at primary care settings under common clinical practice conditions.
METHODS
Epidemiologic, observational, and descriptive study (EPIDEPOC study). Patients > or = 40 years of age with stable COPD attending primary care settings were included. Demographic, clinical characteristics, quality of life (SF-12), seriousness of the disease, and treatment data were collected. Results were compared between patients with or without associated heart disease.
RESULTS
A total of 9,390 patients with COPD were examined of whom 1,770 (18.8%) had heart disease and 78% were males. When comparing both patient groups, significant differences were found in the socio-demographic characteristics, health profile, comorbidities, and severity of the airway obstruction, which was greater in patients with heart disease. Differences were also found in both components of quality of life, physical and mental, with lower scores among those patients with heart disease. Higher frequency of primary care and pneumologist visits, emergency-room visits and number of hospital admissions were observed among patients with heart diseases. The annual total cost per patient was significantly higher in patients with heart disease; 2,937 +/- 2,957 vs. 1,749 +/- 2,120, p < 0.05. Variables that were showed to be independently associated to COPD in subjects with hearth conditions were age, being inactive, ex-smokers, moderate physical exercise, body mass index, concomitant blood hypertension, diabetes, anxiety, the SF-12 physical and mental components and per patient per year total cost.
CONCLUSION
Patients with COPD plus heart disease had greater disease severity and worse quality of life, used more healthcare resources and were associated with greater costs compared to COPD patients without known hearth disease.
背景
评估心脏病对临床特征、生活质量、卫生资源利用和成本的影响，这些患者在常规临床实践条件下于基层医疗保健机构接受治疗。
方法
采用流行病学、观察性、描述性研究（EPIDEPOC 研究）。纳入年龄≥40 岁、稳定期 COPD 患者，在基层医疗保健机构就诊。收集人口统计学、临床特征、生活质量（SF-12）、疾病严重程度和治疗数据。比较合并和不合并心脏病患者的结果。
结果
共检查了 9390 例 COPD 患者，其中 1770 例（18.8%）合并心脏病，78%为男性。比较两组患者，在社会人口统计学特征、健康状况、合并症和气道阻塞严重程度方面存在显著差异，合并心脏病患者的气道阻塞严重程度更高。生活质量的两个组成部分（身体和心理）也存在差异，合并心脏病患者的评分较低。合并心脏病患者的基层医疗保健和肺病专家就诊、急诊就诊和住院次数更多。合并心脏病患者的每位患者年总成本明显较高；2937±2957 比 1749±2120，p<0.05。在患有心脏病的患者中，被证明与 COPD 独立相关的变量是年龄、不活动、前吸烟者、适度体力活动、体重指数、并存高血压、糖尿病、焦虑、SF-12 身体和心理成分以及每位患者每年的总成本。
结论
合并 COPD 和心脏病的患者疾病严重程度更高，生活质量更差，使用更多的医疗资源，且与未确诊心脏病的 COPD 患者相比，成本更高。
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