Eroglu Selma Aydogan, Gunen Hakan, Yakar Halil Ibrahim, Yildiz Ethem, Kavas Murat, Duman Dildar
Sureyyapasa Research and Training Center for Chest Diseases and Thoracic Surgery, Health Sciences University, Istanbul, Turkey.
Department of Pulmonary Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
J Thorac Dis. 2019 Apr;11(4):1379-1386. doi: 10.21037/jtd.2019.03.78.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity around the world, with comorbidities in COPD being common and having a negative effect on survival. We investigate the effects of comorbidities on long-term survival of COPD patients.
The study included patients with COPD who were hospitalized with an exacerbation. The demographic characteristics, hematological and biochemical parameters, pulmonary function test parameters and comorbidities of the patients were obtained from the hospital database and patient records, and the mortality of the patients was assessed at two years. The parameters considered to be related to mortality were analyzed using the Cox regression method.
A total of 826 patients with COPD were included in the study, and the rate of patients with at least one comorbidity was 84.5%. The most common comorbidities were hypertension (n=394, 47.7%), heart failure (n=244, 29.5%) and DM (n=173, 20.9%). In a Cox regression analysis, the Charlson Comorbidity Index was strongly associated with mortality (P=0.000). In Kaplan-Meier analysis, a significant association was noted between the increasing number of comorbidities and long-term mortality, when compared to the patients without comorbidity (comorbidity numbers 1, 2 and ≥3; HR: 1.37, P=0.032, HR: 1.40, P=0.028 and HR: 1.65, P=0.000, respectively).
Increasing number of comorbidities in COPD patients with severe exacerbation were found to negatively affect long-term survival. We consider both the evaluation and treatment of comorbidities to be important in the reduction of long-term mortality in patients with COPD.
慢性阻塞性肺疾病（COPD）是全球主要的死亡和发病原因之一，COPD合并症很常见，且对生存率有负面影响。我们研究合并症对COPD患者长期生存的影响。
该研究纳入因病情加重而住院的COPD患者。从医院数据库和患者记录中获取患者的人口统计学特征、血液学和生化参数、肺功能测试参数及合并症情况，并在两年时评估患者的死亡率。使用Cox回归方法分析被认为与死亡率相关的参数。
该研究共纳入826例COPD患者，至少有一种合并症的患者比例为84.5%。最常见的合并症为高血压（n = 394，47.7%）、心力衰竭（n = 244，29.5%）和糖尿病（n = 173，20.9%）。在Cox回归分析中，Charlson合并症指数与死亡率密切相关（P = 0.000）。在Kaplan-Meier分析中，与无合并症的患者相比，合并症数量增加与长期死亡率之间存在显著关联（合并症数量为1、2和≥3；HR分别为：1.37，P = 0.032；1.40，P = 0.028；1.65，P = 0.000）。
发现重度加重的COPD患者合并症数量增加对长期生存有负面影响。我们认为对合并症的评估和治疗对于降低COPD患者的长期死亡率均很重要。
