Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan.
Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Sci Rep. 2020 Dec 3;10(1):21025. doi: 10.1038/s41598-020-78325-y.
Comorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017-2.198], malignancy (IRR 2.397; 95% CI 1.408-4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612-5.318), heart failure (IRR 2.531; 95% CI 1.502-4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176-3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.
合并症会影响慢性阻塞性肺疾病（COPD）患者的生活质量和生存，及时识别和管理合并症对于 COPD 患者的护理非常重要。本研究旨在探讨 COPD 对其合并症长期发展轨迹的影响。2010 年至 2013 年，所有经肺量计确诊的 COPD 患者均进行了为期 5 年的随访，将这些患者作为病例。获得了 COPD 病例中合并症的患病率及其轨迹，并与年龄、性别、吸烟状况和 Charlson 合并症指数（CCI）相匹配的非 COPD 对照组进行了比较。在研究期间，共纳入了 682 例患者，其中 COPD 组和对照组各 341 例，患者平均年龄为 69.1 岁，89%为男性。两组患者的基线平均 CCI 均为 1.9，5 年后分别增加至 3.4 和 2.7（均 P < 0.001）。通过 5 年的随访，COPD 组观察到所有感兴趣的合并症的患病率显著增加，且高血压（发病率比 1.495；95%置信区间 1.017-2.198）、恶性肿瘤（发病率比 2.397；95%置信区间 1.408-4.081）、糖尿病（发病率比 2.927；95%置信区间 1.612-5.318）、心力衰竭（发病率比 2.531；95%置信区间 1.502-4.265）和消化性溃疡病（发病率比 2.073；95%置信区间 1.176-3.654）的发病率显著高于非 COPD 匹配对照组。总之，我们的研究结果表明，COPD 的存在可能被认为是某些合并症发生的致病因素。
