Díez Manglano J, Bernabeu-Wittel M, Escalera-Zalvide A, Sánchez-Ledesma M, Mora-Rufete A, Nieto-Martín D, Barbé Gil-Ortega J, Moreno-Gaviño L
Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
Rev Clin Esp. 2011 Nov;211(10):504-10. doi: 10.1016/j.rce.2011.04.006. Epub 2011 Oct 5.
To determine the association between different comorbidities and other clinical conditions with mortality in patients with multiple diseases (PMD) suffering from chronic obstructive pulmonary disease (COPD).
Patients with COPD and PMD criteria were included in an observational, prospective and multicentrer study. Data on age, gender, Charlson index, Barthel index, Lawton-Brody index, Pfeiffer test, sociofamilial Gijon scale, education level, hospitalizations during the previous 3 and 12 months and survival at one year were collected. The relationship between the variables and mortality were established by means of a univariate analysis and logistic regression model.
A total of 688 PMD with COPD and mean age of 77.9 years were included. The mean score one the Charlson index was 3.99 (2.07). The most frequent comorbidities were heart failure (59%), diabetes (48%), myocardial infarction (29%), moderate kidney failure (22%), cerebrovascular disease (19%), hypertension (71%), anemia (62%), atrial fibrillation (34%), dyslipidemia (28%) and obesity (21%). A total of 26% of patients were dependent for activities of daily living, 47% needed a caregiver and 54% were at risk of having social problems. At one year, 258 patients (37%) had died. The Charlson index, dependency for activities of daily living and anemia were associated with mortality and hypertension and capacity for reading and writing were associated with survival.
Comorbidity and discapacity are two prognostic factors in COPD patients.
确定慢性阻塞性肺疾病(COPD)合并多种疾病(PMD)患者中不同合并症及其他临床状况与死亡率之间的关联。
符合COPD和PMD标准的患者纳入一项观察性、前瞻性多中心研究。收集患者的年龄、性别、查尔森指数、巴氏指数、劳顿-布罗迪指数、 Pfeiffer测试、社会家庭希洪量表、教育水平、过去3个月和12个月的住院情况以及1年生存率等数据。通过单因素分析和逻辑回归模型确定变量与死亡率之间的关系。
共纳入688例患有COPD且平均年龄为77.9岁的PMD患者。查尔森指数的平均得分为3.99(2.07)。最常见的合并症为心力衰竭(59%)、糖尿病(48%)、心肌梗死(29%)、中度肾衰竭(22%)、脑血管疾病(19%)、高血压(71%)、贫血(62%)、心房颤动(34%)、血脂异常(28%)和肥胖(21%)。共有26%的患者日常生活活动需要依赖他人,47%的患者需要照料者,54%的患者存在社会问题风险。1年后,258例患者(37%)死亡。查尔森指数、日常生活活动依赖和贫血与死亡率相关,而高血压以及读写能力与生存率相关。
合并症和功能障碍是COPD患者的两个预后因素。