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一项针对住院的慢性阻塞性肺疾病相关肺动脉高压的患病率研究。

A prevalence study focusing on hospitalized COPD related pulmonary hypertension.

作者信息

Chang Ting-Chia, Wang Ching-Min, Ho Chung-Han, Chen Yi-Chen, Liao Chia-Te, Shieh Jiunn-Min, Chang Wei-Ting

机构信息

Department of Internal Medicine, College of Medicine, Chi-Mei Medical Center, Tainan, Taiwan.

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Sci Rep. 2025 Apr 11;15(1):12426. doi: 10.1038/s41598-025-96629-9.

Abstract

Pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD) contributes to mortality. Existing epidemiological research is limited in scale, leading to varied prevalence estimates. Hereby, we aim to evaluate the prevalence and impact of COPD-related PH in individuals with COPD. We used medical-claims data from the national health insurance database (NHIRD) of Taiwan (2009 to 2018). The index date was defined as the initial hospitalization for COPD. We identified patients above 40 year-old with a COPD diagnosis from inpatient claims data and stratified rates of COPD-related PH by gender, age, and COPD severity. We compared short- and long-term mortality between COPD patients with and without PH. To ensure the reliability of our findings, we performed a sensitivity analysis by excluding patients who had not undergone echocardiography. Among 215,292 patients hospitalized primarily for COPD, we found an average COPD-related PH prevalence of 39.9 per 1000 individuals. The annual trend significant declined in prevalence among men but was comparable among women. Furthermore, a higher frequency of COPD-related hospitalization or emergency department visits correlated with an elevated COPD-related PH prevalence, irrespective of age. In comparison to COPD patients without PH, those with this condition exhibited notably higher one-year, three-year, and five-year mortality rates. Collectively, despite a declining trend in COPD-related PH prevalence among COPD patients, its development is closely linked to the severity of COPD. Given the significantly increased mortality rates in COPD patients with PH, early detection of this condition and the implementation of related interventions should be prioritized.

摘要

与慢性阻塞性肺疾病(COPD)相关的肺动脉高压(PH)会导致死亡。现有的流行病学研究规模有限,导致患病率估计各不相同。因此,我们旨在评估COPD患者中COPD相关PH的患病率及其影响。我们使用了台湾国民健康保险数据库(NHIRD,2009年至2018年)中的医疗理赔数据。索引日期定义为COPD的首次住院日期。我们从住院理赔数据中识别出年龄在40岁以上且诊断为COPD的患者,并按性别、年龄和COPD严重程度对COPD相关PH的发生率进行分层。我们比较了有和没有PH的COPD患者的短期和长期死亡率。为确保研究结果的可靠性,我们通过排除未接受超声心动图检查的患者进行了敏感性分析。在主要因COPD住院的215,292名患者中,我们发现COPD相关PH的平均患病率为每1000人中有39.9人。男性患病率呈显著下降趋势,而女性患病率则相当。此外,无论年龄大小,COPD相关住院或急诊就诊频率较高与COPD相关PH患病率升高相关。与没有PH的COPD患者相比,患有这种疾病的患者的1年、3年和5年死亡率明显更高。总体而言,尽管COPD患者中COPD相关PH患病率呈下降趋势,但其发展与COPD的严重程度密切相关。鉴于患有PH的COPD患者死亡率显著增加,应优先对这种情况进行早期检测并实施相关干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b03e/11992209/2b0cdfa10b86/41598_2025_96629_Fig1_HTML.jpg

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