Krishnan Jamuna K, Criner Gerard J, Lashari Bilal H, Martinez Fernando J, Kim Victor, Lindoulsi Arthur, Khokhlovich Edward, Altman Pablo, Karcher Helene, Schoenberger Matthias
Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, New York, New York, United States.
Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States.
Chronic Obstr Pulm Dis. 2025 Mar 27;12(2):127-136. doi: 10.15326/jcopdf.2024.0565.
Chronic bronchitis (CB), classically defined as having cough and sputum production for at least 3 months per year for 2 consecutive years, is frequently associated with chronic obstructive pulmonary disease (COPD).
This retrospective cohort study using the Optum de-identified electronic health record data set (Optum EHR) aimed to identify patients with CB, COPD, and both CB and COPD through the application of the classical definition of CB, and to compare the characteristics of these populations, and the timing of diagnosis as well as their health care resource utilization (HCRU). Scanning of the EHRs was performed electronically using a specially developed algorithm.
Of 104,633,876 patients in the study period between January 2007 and September 2020, 628,545 patients had CB only (i.e., nonobstructive disease), 129,084 had COPD only (COPD cohort), and 77,749 had both COPD and CB (COPD-CB cohort). A total of 75.9% of patients (59,009 of 77,749) fulfilled the criteria for a CB diagnosis before their first diagnosis with COPD, compared with 24.1% who had COPD before being diagnosed with CB. HCRU over 5 years was highest in the COPD-CB cohort, whereas the COPD cohort and CB cohorts had similar HCRU over 5 years. The COPD-CB cohort had a greater percentage of common COPD comorbidities and exposure to more drug classes than the other cohorts.
These results highlight the importance of increased attention to CB. CB often precedes the diagnosis of COPD and subsequently leads to high HCRU. Interventions to better manage CB and prevent the progression of CB to COPD could improve morbidity in this population.
慢性支气管炎（CB），传统定义为连续两年每年有至少3个月的咳嗽和咳痰，常与慢性阻塞性肺疾病（COPD）相关。
这项回顾性队列研究使用Optum去识别电子健康记录数据集（Optum EHR），旨在通过应用CB的经典定义识别出患有CB、COPD以及同时患有CB和COPD的患者，并比较这些人群的特征、诊断时间以及他们的医疗资源利用（HCRU）。使用专门开发的算法对电子健康记录进行电子扫描。
在2007年1月至2020年9月的研究期间，104633876名患者中，628545名患者仅患有CB（即非阻塞性疾病），129084名患者仅患有COPD（COPD队列），77749名患者同时患有COPD和CB（COPD-CB队列）。共有75.9%的患者（77749名中的59009名）在首次诊断为COPD之前就符合CB诊断标准，相比之下，24.1%的患者在被诊断为CB之前患有COPD。COPD-CB队列5年的HCRU最高，而COPD队列和CB队列5年的HCRU相似。与其他队列相比，COPD-CB队列中常见COPD合并症的比例更高，接触的药物种类更多。
这些结果凸显了加强对CB关注的重要性。CB通常先于COPD的诊断，随后导致高HCRU。更好地管理CB并预防CB进展为COPD的干预措施可能会改善该人群的发病率。
