Fumagalli Giorgio, Fabiani Fabrizio, Forte Silvia, Napolitano Massimiliano, Marinelli Paolo, Palange Paolo, Pentassuglia Antonella, Carlone Stefano, Sanguinetti Claudio Maria
Pulmonary Department of San Filippo Neri General Hospital, Rome, Italy.
Multidiscip Respir Med. 2013 Apr 3;8(1):28. doi: 10.1186/2049-6958-8-28.
Chronic Obstructive Pulmonary Disease (COPD) is often associated with comorbidities, especially cardiovascular, that have a heavy burden in terms of hospitalization and mortality. Since no conclusive data exist on the prevalence and type of comorbidities in COPD patients in Italy, we planned the INDACO observational pilot study to evaluate the impact of comorbidities in patients referred to the outpatient wards of four major hospitals in Rome.
For each patient we recorded anthropometric and anamnestic data, smoking habits, respiratory function, GOLD (Global initiative for chronic Obstructive Lung Disease) severity stage, Body Mass Index (BMI), number of acute COPD exacerbations in previous years, presence and type of comorbidities, and the Charlson Comorbidity Index (CCI).
Here we report and discuss the results of the first 169 patients (124 males, mean age 74±8 years). The prevalence of patients with comorbidities was 94.1% (25.2% of cases presented only one comorbidity, 28.3% two, 46.5% three or more). There was a high prevalence of arterial hypertension (52.1%), metabolic syndrome (20.7%), cancers (13.6%) and diabetes (11.2%) in the whole study group, and of anxiety-depression syndrome in females (13%). Exacerbation frequency was positively correlated with dyspnea score and negatively with BMI. Use of combination of bronchodilators and inhaled corticosteroids was more frequent in younger patients with more severe airways obstruction and lower CCI.
These preliminary results show a high prevalence of comorbidities in COPD patients attending four great hospitals in Rome, but they need to be confirmed by further investigations in a larger patients cohort.
慢性阻塞性肺疾病（COPD）常伴有合并症，尤其是心血管疾病，这些合并症在住院率和死亡率方面负担沉重。由于意大利COPD患者合并症的患病率和类型尚无确凿数据，我们开展了INDACO观察性试点研究，以评估合并症对罗马四家主要医院门诊病房患者的影响。
我们记录了每位患者的人体测量和既往病史数据、吸烟习惯、呼吸功能、慢性阻塞性肺疾病全球倡议（GOLD）严重程度分级、体重指数（BMI）、前几年急性COPD加重的次数、合并症的存在情况和类型，以及查尔森合并症指数（CCI）。
在此，我们报告并讨论前169例患者（124例男性，平均年龄74±8岁）的结果。合并症患者的患病率为94.1%（25.2%的病例仅有一种合并症，28.3%有两种，46.5%有三种或更多）。在整个研究组中，动脉高血压（52.1%）、代谢综合征（20.7%）、癌症（13.6%）和糖尿病（11.2%）的患病率较高，女性中焦虑抑郁综合征的患病率为13%。急性加重频率与呼吸困难评分呈正相关，与BMI呈负相关。在气道阻塞更严重、CCI较低的年轻患者中，联合使用支气管扩张剂和吸入性糖皮质激素更为频繁。
这些初步结果表明，在罗马四家大型医院就诊的COPD患者中合并症的患病率较高，但需要在更大的患者队列中进行进一步调查以证实这些结果。
