Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Cardiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
PLoS One. 2023 Jul 7;18(7):e0288237. doi: 10.1371/journal.pone.0288237. eCollection 2023.
Nation-wide hospitalization databases include diagnostic information at the level of an entire population over an extended period of time. Comorbidity network and early disease development can be unveiled. Chronic obstructive pulmonary disease (COPD) is an underdiagnosed condition for which it is crucial to identify early disease indicators. The identification of gender-specific conditions preceding the onset of COPD may reveal disease progression patterns allowing for early diagnosis and intervention. The objective of the study was to investigate the antecedent hospitalization history of patients newly diagnosed with COPD and to retrace a gender-specific trajectory of coded entities prior to the onset of COPD.
A population-wide hospitalization database including information about all hospitalizations in Switzerland between 2002 and 2018 was used. COPD cases were extracted from the database and comorbidities occurring prior to the onset of COPD identified. Comorbidities significantly over-represented in COPD compared with a 1:1, age- and sex-matched control population were identified and their longitudinal evolution was analyzed.
Between 2002 and 2018, 697,714 hospitalizations with coded COPD were recorded in Switzerland. Sixty-two diagnoses were significantly over-represented before onset of COPD. These preceding comorbidities included both well-established conditions and novel links to COPD. Early pre-conditions included nicotine and alcohol abuse, obesity and cardiovascular diseases. Later comorbidities included atrial fibrillation, diseases of the genitourinary system and pneumonia. Atherosclerotic heart diseases were more prevalent in males, whereas hypothyroidism, varicose and intestinal disorders were more frequent in females. Disease trajectories were validated using an independent data set.
Gender-specific disease trajectories highlight early indicators and pathogenetic links between COPD and antecedent diseases and could allow for early detection and intervention.
全国性住院数据库包含在较长时间内整个人群的诊断信息。可以揭示合并症网络和早期疾病发展。慢性阻塞性肺疾病（COPD）是一种诊断不足的疾病，识别早期疾病指标至关重要。识别 COPD 发病前的特定性别疾病可能会揭示疾病进展模式，从而实现早期诊断和干预。本研究的目的是调查新诊断为 COPD 的患者的住院前病史，并追溯 COPD 发病前编码实体的特定性别轨迹。
使用包括 2002 年至 2018 年瑞士所有住院信息的全国性住院数据库。从数据库中提取 COPD 病例，并确定 COPD 发病前的合并症。确定与 COPD 相比明显过度表达的合并症，并分析其纵向演变。
2002 年至 2018 年间，瑞士共记录了 697714 例编码 COPD 的住院病例。62 种诊断在 COPD 发病前明显过度表达。这些先前的合并症包括既定疾病和与 COPD 的新联系。早期的前期疾病包括尼古丁和酒精滥用、肥胖和心血管疾病。后来的合并症包括心房颤动、泌尿生殖系统疾病和肺炎。动脉粥样硬化性心脏病在男性中更为常见，而甲状腺功能减退症、静脉曲张和肠道疾病在女性中更为常见。使用独立数据集验证了疾病轨迹。
特定性别疾病轨迹突出了 COPD 与先前疾病之间的早期指标和发病机制联系，并可能实现早期检测和干预。
