Kumbhare Suchit D, Beiko Tatsiana, Wilcox Susan R, Strange Charlie
Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston.
Division of Emergency Medicine, Department of Medicine, Medical University of South Carolina, Charleston.
Chronic Obstr Pulm Dis. 2016 Mar 28;3(2):539-548. doi: 10.15326/jcopdf.3.2.2015.0155.
Several chronic obstructive pulmonary disease (COPD) studies have evaluated risk factors for emergency department (ED) visits or hospitalizations, and found insufficient data available about social and demographic factors that drive these behaviors. This U.S. study was designed to describe the characteristics of COPD patients with ED visits or a hospitalization and to investigate how often common COPD comorbidities are present in these individuals. Data for 7180 COPD patients regarding demographic factors, comorbidities, smoking status, and ED visits or hospitalization was obtained from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey. Logistic regression analysis was used to adjust demographic factors and smoking status to model the correlation between patients with ED visits or hospitalizations and morbidities generating odds ratios (OR) and confidence intervals (CI). Among diagnosed COPD patients in the BRFSS, 16.5% had ED visits or hospitalization in the previous year. These individuals were younger, had a lower socio-economic status (lower education, lower income, and more often unemployed) and 23.4% of the individuals could not visit a doctor because of the financial difficulties compared to 16.7% who had no visit (<0.0001 for all comparisons). The prevalence of comorbidities was higher in those with ED visits or hospitalization compared to those without. In a population representative of COPD patients, lower socio-economic status and higher comorbidities are associated with ED visits or hospitalization. Studies are needed to further elucidate the complex relationship between COPD, comorbidities, and ED visits or hospitalization.
多项慢性阻塞性肺疾病（COPD）研究评估了急诊科就诊或住院的风险因素，发现关于促使这些行为发生的社会和人口因素的数据不足。这项美国研究旨在描述有急诊科就诊或住院史的COPD患者的特征，并调查这些个体中常见COPD合并症的出现频率。从2012年行为危险因素监测系统（BRFSS）调查中获取了7180名COPD患者的人口统计学因素、合并症、吸烟状况以及急诊科就诊或住院情况的数据。采用逻辑回归分析来调整人口统计学因素和吸烟状况，以建立急诊科就诊或住院患者与合并症之间的相关性模型，生成比值比（OR）和置信区间（CI）。在BRFSS中被诊断为COPD的患者中，16.5%在上一年有急诊科就诊或住院史。这些个体更年轻，社会经济地位较低（教育程度较低、收入较低且失业更为常见），23.4%的个体因经济困难无法就医，而未就诊的个体为16.7%（所有比较的P<0.0001）。与未就诊或住院的患者相比，有急诊科就诊或住院史的患者合并症患病率更高。在具有COPD患者代表性的人群中，较低的社会经济地位和较高的合并症与急诊科就诊或住院相关。需要开展研究以进一步阐明COPD、合并症与急诊科就诊或住院之间的复杂关系。
