COPD患者不同合并症的患病率(按性别和GOLD分期)。

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2015-08-05 eCollection Date: 2015-01-01 DOI:10.1186/s40248-015-0023-2
R W Dal Negro, L Bonadiman, P Turco
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引用次数: 100

摘要

背景:几种合并症经常影响COPD的进展。该研究的目的是根据性别和疾病严重程度评估首次转诊到专科机构的COPD患者队列中主要合并症的患病率。方法:该研究是一项非干预性的横断面调查,通过从2012-2015年期间的机构数据库中自动和匿名选择进行。纳入标准为:年龄≥40岁的男女受试者;根据2014年GOLD指南诊断COPD;完整临床记录文件的可用性。收集的变量包括:肺功能;吸烟史;BMI;Charlson共病指数(CCI);每个患者合并症的数量和种类。结果:78.6%的患者中至少发现一种具有临床相关性的合并症,但68.8%的患者中发现至少两种,47.9%的受试者中发现三种或更多种。平均CCI为3.4 ± 1.6sd。总体患病率为每位患者2.6种合并症,但男性为2.5种,女性为3.0种(p 结论:所有合并症的患病率都在逐渐增加,直到COPD严重程度的最后阶段,但心血管和代谢合并症除外,这些合并症在IV GOLD阶段有所下降,这可能是由于该严重COPD阶段的高死亡率。合并症的性别依赖性在总体上得到了证实,即使癌症几乎与性别无关地急剧增加。
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Prevalence of different comorbidities in COPD patients by gender and GOLD stage.

Background: Several comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution.

Methods: The study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012-2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file. Variables collected were: lung function; smoking history; BMI; the Charlson Comorbidity Index (CCI); number and kind of comorbidities for each patient.

Results: At least one comorbidity of clinical relevance was found in 78.6 % of patients, but at least two in 68.8 %, and three or more were found in 47.9 % of subjects. Mean CCI was 3.4 ± 1.6sd. The overall prevalence was 2.6 comorbidities per patient, but 2.5 in males, and 3.0 in females, respectively (p < 0.05). Cardio-vascular disorders were the most frequent, but significantly more frequent in males (44.7 vs 30.7 %, respectively), while the metabolic, the digestive and the osteo-articular disorders were prevailing in females (12.4 vs 9.2; 14.2 vs 4.8, and 6.0 vs 3.8, respectively). In particular, chronic cor pumonale and arrhythmias mainly prevailed in men and congestive heart failure in females, while arterial hypertension resulted equally distributed. As concerning respiratory disorders, pneumonia, pleural effusions and chronic respiratory failure were more frequently found in men, while bronchiectasis and asthma-COPD overlap syndrome (ACOS) in females. Anaemia, gall bladder stones, osteoporosis and spontaneous fractures mostly prevailed in females, while gastric disorders of inflammatory origin and arthrosis were more frequent in males. Cognition disorders, dementia and signs of degenerative brain disorders were more frequently found in men, while depression in females. Finally, lung cancer was at the first place in men, but at the second in females.

Conclusions: All comorbidities increased their prevalence progressively up to the last stage of COPD severity, except the cardio-vascular and the metabolic ones which dropped in the IV GOLD stage, presumably due to the high mortality rate in this severe COPD stage. The gender-dependency of comorbidities was confirmed in general terms, even if lung cancer proved a dramatic increase almost independently of sex.

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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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