Johns Hopkins School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland 21224, USA.
COPD. 2013 Jun;10(3):324-32. doi: 10.3109/15412555.2012.744963.
Chronic Obstructive Pulmonary Disease (COPD) coexists with co-morbidities. While co-morbidity has been associated with poorer health status, it is unclear which conditions have the greatest impact on self-rated health. We sought to determine which, and how much, specific co-morbid conditions impact on self-rated health in current and former smokers with self-reported COPD. Using the 2001-2008 National Health and Nutrition Examination Survey we characterized the association between thirteen co-morbidities and health status among individuals self-reporting COPD. Adjusted odds ratios (ORs) were generated using ordinal logistic regression. Additionally we evaluated the impact of increasing number of co-morbidities with self-rated health. Eight illnesses had significant associations with worse self-rated health, however after mutually adjusting for these conditions, congestive heart failure (OR 3.07, 95% CI 1.69-5.58), arthritis (OR 1.69, 95% CI 1.13-2.52), diabetes (OR 1.63, 95% CI 1.01-2.64), and incontinence/prostate disease (OR 1.63, 95% CI 1.01-2.62) remained independent predictors of self-rated health. Each increase in co-morbidities was associated with a 43% higher chance of worse self-rated health (95% CI 1.27-1.62). Individuals with COPD have a substantial burden of co-morbidity, which is associated with worse self-rated health. CHF, arthritis, diabetes and incontinence/prostate disease have the most impact on self-rated health. Targeting these co-morbidities in COPD may result in improved self-rated health.
慢性阻塞性肺疾病（COPD）与合并症共存。虽然合并症与健康状况较差有关，但尚不清楚哪些疾病对自我评估健康的影响最大。我们旨在确定在自我报告患有 COPD 的当前和前吸烟者中，哪些特定的合并症以及它们对自我评估健康的影响程度最大。我们使用 2001-2008 年全国健康和营养检查调查，描述了 13 种合并症与报告患有 COPD 的个体健康状况之间的关联。使用有序逻辑回归生成调整后的优势比（OR）。此外，我们还评估了随着自我评估健康状况的恶化，合并症数量增加的影响。有八种疾病与自我评估健康状况较差有显著关联，但在相互调整这些疾病后，充血性心力衰竭（OR 3.07，95%CI 1.69-5.58），关节炎（OR 1.69，95%CI 1.13-2.52），糖尿病（OR 1.63，95%CI 1.01-2.64）和尿失禁/前列腺疾病（OR 1.63，95%CI 1.01-2.62）仍然是自我评估健康的独立预测因素。每增加一种合并症，自我评估健康状况恶化的可能性就会增加 43%（95%CI 1.27-1.62）。患有 COPD 的个体合并症负担沉重，这与自我评估健康状况较差有关。充血性心力衰竭、关节炎、糖尿病和尿失禁/前列腺疾病对自我评估健康的影响最大。针对 COPD 中的这些合并症可能会改善自我评估健康状况。
