Department of Public Health and Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
BMJ Open Respir Res. 2024 Mar 14;11(1):e001959. doi: 10.1136/bmjresp-2023-001959.
Asthma is a common chronic disease characterised by variable respiratory symptoms and airflow limitation, affecting roughly 4%-10% of the adult population. Adult asthma is associated with higher all-cause mortality compared to individuals without asthma. In this study, we investigate the comorbidities that may affect the management of asthma.
Total of 1648 adults with asthma and 3310 individuals without asthma aged 30-93 were matched with age, gender and area of residency, and followed from 1 January 1997 to 31 December 2013. Baseline information was collected with questionnaires 1997 and follow-up register data from the national discharge registry Finnish Institute for Health and Welfare. Data included diagnoses from outpatient care and day surgery of specialised health care, and data from inpatient care of specialised and primary health care. We included all main diagnoses that had at minimum 200 events and number of diagnoses based on their common appearance with adult asthma.
The mean follow-up time varied between 14.2 and 15.1 years, and age at the time of enrolment was 53.9 years for subjects without asthma and 54.4 years for patients with asthma. Chronic obstructive pulmonary disease was 10 times more common among asthmatics. Risk of acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis and vocal cord dysfunction was fourfold and risk of pneumonia, and chronic rhinosinusitis was 2.5 times more common among asthmatics. Sleep apnoea, gastro-oesophageal reflux disease, diabetes, allergic rhinitis and dysfunctional breathing were twofold and cataract nearly twofold higher in the asthmatic group. Adult asthma was also significantly associated with musculoskeletal diseases, incontinence and bronchiectasis.
The most common and most severe comorbidity of adult asthma in this study was chronic obstructive pulmonary disease. Other common comorbidities of adult asthma include acute rhinosinusitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, allergic rhinitis, dysfunctional breathing, diabetes, pneumonia, sleep apnoea and gastro-oesophageal reflux disease.
哮喘是一种常见的慢性疾病，其特征为呼吸症状和气流受限的可变性，影响大约 4%-10%的成年人口。与没有哮喘的个体相比，成人哮喘与更高的全因死亡率相关。在这项研究中，我们调查了可能影响哮喘管理的合并症。
总共纳入了 1648 名哮喘成人和 3310 名无哮喘成人，他们在年龄、性别和居住地区方面与哮喘成人相匹配，并于 1997 年 1 月 1 日至 2013 年 12 月 31 日期间进行随访。基线信息通过 1997 年的问卷调查收集，随访数据来自国家出院登记处芬兰卫生与福利研究所。数据包括来自专科保健门诊和日间手术的诊断，以及来自专科和初级保健住院治疗的诊断。我们纳入了所有至少有 200 次事件的主要诊断，以及根据与成人哮喘共同出现的常见情况进行的诊断数量。
平均随访时间在 14.2 至 15.1 年之间，无哮喘者的入组年龄为 53.9 岁，哮喘者的入组年龄为 54.4 岁。哮喘患者中慢性阻塞性肺疾病的发病率是 10 倍。急性鼻-鼻窦炎、伴鼻息肉的慢性鼻-鼻窦炎、特应性皮炎和声带功能障碍的风险增加了 4 倍，肺炎和慢性鼻-鼻窦炎的风险增加了 2.5 倍。哮喘患者的睡眠呼吸暂停、胃食管反流病、糖尿病、变应性鼻炎和呼吸功能障碍的风险增加了 2 倍，白内障的风险增加了近 2 倍。成人哮喘还与肌肉骨骼疾病、尿失禁和支气管扩张显著相关。
在这项研究中，成人哮喘最常见和最严重的合并症是慢性阻塞性肺疾病。成人哮喘的其他常见合并症包括急性鼻-鼻窦炎、伴鼻息肉的慢性鼻-鼻窦炎、特应性皮炎、变应性鼻炎、呼吸功能障碍、糖尿病、肺炎、睡眠呼吸暂停和胃食管反流病。
