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过去一年中合并症与哮喘恶化住院的年度发生率和频率之间的关联:来自 CARN 研究的数据。

Associations between comorbidities and annual incidence plus frequency of asthma exacerbation hospitalisation during the past year: data from CARN study.

机构信息

Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, China.

Department of Respiration, Shanghai Central Hospital, Shanghai, China.

出版信息

BMC Pulm Med. 2022 Jul 1;22(1):261. doi: 10.1186/s12890-022-02038-3.

Abstract

PURPOSE

While asthma comorbidities are associated with higher health care utilisation, lower quality of life and poorer asthma control, the impact of asthma comorbidities on hospitalisation for asthma exacerbation (H-AX) remains less recognised. We aim to analyse the impact of asthma comorbidities on H-AX.

METHODS

Based on a national survey on asthma control and disease perception (CARN 2015 study), we analysed the impact of comorbidities on annual incidence and frequency of H-AX in China. Information on demographic characteristics, asthma comorbidities and annual incidence and frequency of H-AX were presented in this study.

RESULTS

Among 3875 ambulatory asthma patients, 75.9% (2941/3875) had comorbidities, and 26.4% (1017/3858) experienced H-AX during past year. After adjusting for confounding factors such as demographic data, smoking status and asthma control, COPD [OR = 2.189, 95% CI (1.673, 2.863)] and coronary heart disease [OR = 1.387, 95% CI (1.032, 1.864)] were associated with higher annual incidence, while allergic rhinitis [OR = 0.692, 95% CI (0.588, 0.815)] was associated with lower annual incidence, of H-AX. In terms of frequency, allergic rhinitis [OR = 1.630, 95% CI (1.214, 2.187)], COPD [OR = 1.472, 95% CI (1.021, 2.122)] and anxiety [OR = 2.609, 95% CI (1.051, 6.477)] showed statistically significant correlation with frequent H-AX.

CONCLUSIONS

COPD and coronary heart disease were associated with higher annual incidence, while allergic rhinitis was associated with lower annual incidence of H-AX. Allergic rhinitis, COPD and anxiety were associated with frequent H-AX. Comorbidities may have an important role in the risk and frequency of annual hospitalisations due to asthma exacerbation. The goal of asthma control should rely on a multi-disciplinary treatment protocol.

摘要

目的

虽然哮喘合并症与更高的医疗保健利用率、更低的生活质量和更差的哮喘控制相关,但哮喘合并症对哮喘加重住院(H-AX)的影响仍未得到充分认识。我们旨在分析哮喘合并症对 H-AX 的影响。

方法

基于一项关于哮喘控制和疾病认知的全国性调查(CARN 2015 研究),我们分析了合并症对中国哮喘患者 H-AX 年发生率和频率的影响。本研究介绍了人口统计学特征、哮喘合并症以及 H-AX 的年发生率和频率信息。

结果

在 3875 名门诊哮喘患者中,75.9%(2941/3875)有合并症,26.4%(1017/3858)在过去一年中经历过 H-AX。在调整了人口统计学数据、吸烟状况和哮喘控制等混杂因素后,COPD[比值比(OR)=2.189,95%置信区间(CI)(1.673,2.863)]和冠心病(OR=1.387,95%CI(1.032,1.864)]与较高的年发生率相关,而过敏性鼻炎(OR=0.692,95%CI(0.588,0.815)]与较低的年发生率相关。就频率而言,过敏性鼻炎(OR=1.630,95%CI(1.214,2.187)]、COPD(OR=1.472,95%CI(1.021,2.122)]和焦虑(OR=2.609,95%CI(1.051,6.477)]与频繁 H-AX 呈统计学显著相关。

结论

COPD 和冠心病与较高的年发生率相关,而过敏性鼻炎与较低的年发生率相关。过敏性鼻炎、COPD 和焦虑与频繁的 H-AX 相关。合并症可能在哮喘加重导致的年度住院风险和频率中发挥重要作用。哮喘控制的目标应依赖于多学科治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8bc/9250194/b842e1fa817c/12890_2022_2038_Fig1_HTML.jpg

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