Rubinsztajn Renata, Chazan Ryszarda
Analiza przyczyn zgonów i chorób współistniejących u hospitalizowanych chorych na przewlekłą obturacyjną chorobę płuc.
Pneumonol Alergol Pol. 2011;79(5):343-6.
Chronic obstructive pulmonary disease (COPD) is a fourth cause of death in USA and is expected to be the third cause of death by year 2020. It is believed that some diseases like cardiovascular diseases, osteoporosis, cachexia, anaemia are systemic consequences of COPD. Some data show that the co-morbidities are more frequent in severe COPD patients than in control groups and are associated with the serious health outcomes. It is debated whether extra pulmonary comorbidities or pulmonary complications are the main reason of death in COPD. The aim of the study was to analyze the mortality and comorbidity in COPD patients who died during hospitalization in the Department of Pneumonology and Allergology in WMU from 2004 to 2008.
We analyzed 266 records of patients who had diagnosis of COPD and died during hospitalization (179 [67%] M and 87 [33%] F). The mean age at death was 73 ± 8 years (M 73 ± 8 years, F 74 ± 9 years).
The most frequent cause of death were: COPD exacerbation (n = 81 [30%], F = 32, M = 49), pneumonia (n = 67 [25%], F = 17, M = 50), lung cancer (n = 50 [19%], F = 18, M = 32), ischemic heart disease (n = 20 [7%], F = 5, M = 15), cardiovascular insufficiency (n = 14 [5%], F = 6, M = 8) and other (n = 34 [14%]). The lung cancer was more frequent cause of death in younger patients (p = 0.002), and pneumonia in older (p = 0.02). In COPD patients the following comorbidities were diagnosed: chronic heart failure (n = 169), hypertension (n = 103), ischaemic heart disease (n = 102), diabetes mellitus type 2 (n = 55), renal insufficiency (n = 43), hypertrophy of prostate (n = 36), arteriosclerosis obliterans (n = 28), osteoporosis (n = 19), anaemia (n = 14) and others.
慢性阻塞性肺疾病（COPD）是美国第四大致死原因，预计到2020年将成为第三大致死原因。人们认为，心血管疾病、骨质疏松症、恶病质、贫血等一些疾病是COPD的全身性后果。一些数据表明，合并症在重度COPD患者中比在对照组中更常见，且与严重的健康后果相关。关于肺外合并症或肺部并发症是否是COPD患者死亡的主要原因存在争议。本研究的目的是分析2004年至2008年在西密歇根大学肺病与过敏科住院期间死亡的COPD患者的死亡率和合并症情况。
我们分析了266例诊断为COPD且在住院期间死亡的患者记录（男性179例[67%]，女性87例[33%]）。平均死亡年龄为73±8岁（男性73±8岁，女性74±9岁）。
最常见的死亡原因是：COPD急性加重（n = 81例[30%]，女性32例，男性49例）、肺炎（n = 67例[25%]，女性17例，男性50例）、肺癌（n = 50例[19%]，女性18例，男性32例）、缺血性心脏病（n = 20例[7%]，女性5例，男性15例）、心血管功能不全（n = 14例[5%]，女性6例，男性8例）及其他（n = 34例[14%]）。肺癌在年轻患者中是更常见的死亡原因（p = 0.002），而肺炎在老年患者中更常见（p = 0.02）。在COPD患者中诊断出以下合并症：慢性心力衰竭（n = 169例）、高血压（n = 103例）、缺血性心脏病（n = 102例）、2型糖尿病（n = 55例）、肾功能不全（n = 43例）、前列腺肥大（n = 36例）、闭塞性动脉硬化（n = 28例）、骨质疏松症（n = 19例）、贫血（n = 14例）及其他。
