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Sort of data by class of COPD exacerbation * Class of COPD exacerbation Age (yrs) FEV 1 % FEV 1 /FVC % PaO 2 mmHg PaCO 2 mmHg BMI Kg/m 2 CCI score MRC score
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Background
Chronic Obstructive Pulmonary Disease (COPD) is often associated with comorbidities, especially cardiovascular, that have a heavy burden in terms of hospitalization and mortality. Since no conclusive data exist on the prevalence and type of comorbidities in COPD patients in Italy, we planned the INDACO observational pilot study to evalua...
Context in source publication
Context 1
... progressive increase in number of exacerbations correlated with the increase in number of comorbidities, without signifi- cance at ANOVA (Figure 4). Moreover, the prevalence of acute exacerbations was positively correlated with dyspnea and negatively with BMI values (Table 2). According to inhaler therapy, patients were divided into 4 groups on the basis of whether they used only LABA and/or LAMA, or fixed combinations of LABA and ICS, or LABA plus ICS plus LAMA. ...
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Citations
... 17 Similarly, the INDACO project, a pilot study on the incidence of co-morbidities in COPD patients found 53% prevalence of hypertension in COPD patients. 18 The results of our study showed a significantly higher prevalence of hypertension among the participants. Despite being the most common co-morbidity in COPD patients this extraordinarily higher frequency might be due to the small sample size and use of IDF criteria which classified hypertension as systolic BP >130 mm of Hg and diastolic BP >85 mm of Hg. ...
Introduction:
Metabolic syndrome; a constellation of obesity, hypertension, and disturbances of lipid and carbohydrate metabolism is a common phenomenon in chronic obstructive pulmonary disease. Systemic inflammation plays an important role in both conditions. The aim of this study was to find out the prevalence of metabolic syndrome among stable chronic obstructive pulmonary disease patients visiting the outpatient Department of a tertiary care centre.
Methods:
A descriptive cross-sectional study was done in the outpatient Department of Pulmonology and General Practice from 1 August 2019 to 31 December 2020. Ethical approval was obtained from Institutional Review Committee [Registration number: 5/(6-11)E2/076/077]. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results:
Among 57 patients with stable chronic obstructive pulmonary disease, the prevalence of metabolic syndrome was 22 (38.59%) (27.48-49.70, 90% Confidence Interval). The prevalence of metabolic syndrome in patients with Global Initiative for Obstructive Lung Disease stages 1, 2, 3, and 4 were 6 (27.27%), 9 (40.90%), 6 (27.27%) and 1 (4.54%) respectively.
Conclusions:
The prevalence of metabolic syndrome was similar to the other studies done in similar settings. The screening of metabolic syndrome is necessary and stratification for cardiovascular disease risk is important for timely intervention to prevent and decrease morbidities and mortalities.
Keywords:
chronic obstructive pulmonary disease; c-reactive protein; metabolic syndrome.
... 17 Similarly, the INDACO project, a pilot study on the incidence of co-morbidities in COPD patients found 53% prevalence of hypertension in COPD patients. 18 The results of our study showed a significantly higher prevalence of hypertension among the participants. Despite being the most common co-morbidity in COPD patients this extraordinarily higher frequency might be due to the small sample size and use of IDF criteria which classified hypertension as systolic BP >130 mm of Hg and diastolic BP >85 mm of Hg. ...
Introduction:
Metabolic syndrome; a constellation of obesity, hypertension, and disturbances of lipid and carbohydrate metabolism is a common phenomenon in chronic obstructive pulmonary disease. Systemic inflammation plays an important role in both conditions. The aim of this study was to find out the prevalence of metabolic syndrome among stable chronic obstructive pulmonary disease patients visiting the outpatient Department of a tertiary care centre.
Methods:
A descriptive cross-sectional study was done in the outpatient Department of Pulmonology and General Practice from 1 August 2019 to 31 December 2020. Ethical approval was obtained from Institutional Review Committee [Registration number: 5/(6-11)E2/076/077]. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results:
Among 57 patients with stable chronic obstructive pulmonary disease, the prevalence of metabolic syndrome was 22 (38.59%) (27.48-49.70, 90% Confidence Interval). The prevalence of metabolic syndrome in patients with Global Initiative for Obstructive Lung Disease stages 1, 2, 3, and 4 were 6 (27.27%), 9 (40.90%), 6 (27.27%) and 1 (4.54%) respectively.
Conclusions:
The prevalence of metabolic syndrome was similar to the other studies done in similar settings. The screening of metabolic syndrome is necessary and stratification for cardiovascular disease risk is important for timely intervention to prevent and decrease morbidities and mortalities.
Keywords:
chronic obstructive pulmonary disease; c-reactive protein; metabolic syndrome.
... and three or more in 46.5-47.9% of subjects. [6,37] In our study, one comorbidity was found in 23.73%, two in 24.19%, and three or more in 27.42%. Most frequently, patients have one or two comorbid conditions of clinical significance. ...
BACKGROUND AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide, and the majority of patients have at least one comorbid condition of clinical significance. Therefore, we studied its prevalence and implication based on experience from the Republic of Moldova.
METHODS: The study was a prospective cohort study that included 435 patients with COPD from 2015 to 2017.
RESULTS: We found heart failure in 38.62% of the patients, hypertension in 50.11%, coronary artery disease in 23.45%, diabetes mellitus in 10.11%, renal failure in 1.15%, rheumatoid arthritis in 3.22%, depression in 4.83%, cognitive impairment in 4.37%, obesity in 29.89%, and cachexia in 3.22%. Only 24.65% of patients did not have comorbidities. One comorbidity was found in 23.73%, two in 24.19%, three or more in 27.42%. The Charlson comorbidity index (CCI) had a medium negative correlation with the 6-minute walking test (r=–0.37, p<0.001) and a weak correlation with the rate of exacerbations (r=0.17, p=0.016). CCI had a strong correlation with ADO (age, dyspnea and airflow obstruction) (r=0.75, p<0.001); moderate with BODE (body mass index, airflow obstruction, dyspnea, and exercise) (r=0.3, p<0.001); and weak with BODEx (body mass index, airflow obstruction, dyspnea, and exacerbations), CODEX (comorbidity, obstruc-
tion, dyspnea, and previous severe exacerbations), and DOSE (dyspnea, obstruction, smoking, and exacerbation). CCI had a medium correlation with St. George’s Respiratory Questionnaire (SGRQ) activity (r=0.36, p<0.001), impact (r=0.34, p<0.001), and total (r=0.37, p<0.001) scores, and the overall quality of life assessed by SGRQ and Clinical COPD Questionnaire.
CONCLUSIONS: Patients with COPD require a multidisciplinary approach to assess and manage a variety of conditions, which influence the evolution and prognosis of COPD. Patients often have one or two comorbidities of clinical significance, and they are predominantly cardiovascular and metabolic. Patients with comorbidities tend to have a poorer health-related quality of life. Comorbidities can be assessed by multidimensional indexes such as ADO and BODE.
... [32] Heart failure The overall prevalence of heart failure in COPD patients with moderate-tosevere airflow limitation in different cohort studies ranges from 7% to 39%, and impairment of left ventricle fraction ejection does not play a role. [33] [34] [35] As in most cases with COPD-related comorbidities, COPD and heart failure are clinically interrelated: while airflow limitation itself major risk factor of heart failure, the latter may result in airflow limitation. [36] [37] Hypertension Across all GOLD stages, hypertension appears to be the cardiovascular comorbidity that is most common. ...
This review’s purpose is to summarize the current state of knowledge on the systemic implication of chronic pulmonary obstructive disease Background: The ‘systemic repercussions’ of COPD are of great importance. These include accidental weight loss, skeletal muscle dysfunction, and a higher risk of cardiovascular disease, osteoporosis, and depression. Frequently affecting the patient’s health and prognosis, these extrapulmonary COPD characteristics demand thorough screening and proper management to give the most effective medical care. Methods: We conducted a search of papers describing COPD as a systematic disease on the MEDLINE database. Discussion: Local and systemic inflammation, oxidative stress, and changes in the neuro-humoral states are some of the likely candidate pathways by which these extrapulmonary complications of COPD are affected, even though the mechanisms for the association of COPD with systemic disorders have not been fully clarified. The processes and mechanisms behind the extrapulmonary symptoms of COPD will likely become more transparent with further research. Conclusion: COPD management should be based on a clear understanding of COPD-related comorbidities and their impact on COPD itself.
... and three or more in 46.5-47.9% of subjects. [6,37] In our study, one co-morbidity was found in 23.73%, two in 24.19%, and three or more in 27.42%. Most frequently, patients have one or two comorbid conditions of clinical significance. ...
... [1][2][3][4] It is known that multimorbidity, defined as the presence of two or more long-term conditions, in COPD patients is highly prevalent. [5][6][7][8] These conditions should be actively monitored and treated early, as they have a negative impact on quality of life, hospitalization and mortality. 9,10 Multimorbidity is a well-known factor that impacts on the complexity of disease management for the health care professional and the patient, while it impairs healthrelated outcomes and quality of life. ...
Objectives
Polypharmacy and multimorbidity in chronic obstructive pulmonary disease (COPD) are highly prevalent, with potential associations with worse COPD outcomes. The aim of this study was to identify the clinical characteristics and outcomes of polypharmacy, investigate the relationship of polypharmacy with health status and exacerbations and assess the prevalence of inappropriate medication (PIM), risk of adverse drug reactions (ADRs) and drug-to-drug interactions in COPD patients.
Methods
A total of 245 COPD patients were enrolled from primary care in Crete, Greece. Patients completed a questionnaire and the COPD Assessment Test (CAT). Multimorbidity was defined as having two or more comorbidities and polypharmacy was defined as taking five or more drugs per day.
Results
Most of COPD patients (77.0%) and the majority (83.6%) of elderly (≥65 years) had multimorbidity, while polypharmacy was evident in 55.2% of all patients and 62.4% in elderly. After adjustments for age, gender and pack-years, polypharmacy was associated with CAT ≥ 10, multimorbidity, several cardiometabolic diseases, cancer and depression–anxiety and prostate disorders (all p values > 0.05). PIMs were found in 9.6% of subjects aged ≥65 years and were mainly mental health medication. Due to coadministration of medications, 22.3% of the population were at cumulative risk for falls, 17% for constipation and 12.8% for cardiovascular events. Finally, 15 pairs of drug-to-drug interactions were identified in 11.5% of patients.
Conclusion
Our data suggest that polypharmacy is highly prevalent and associated with worse health status and prescription risks in COPD patients. These findings potentially introduce an additional challenge on effective management of these patients.
... In our study, smoking was associated with majority of patients in both study and control groups (56% and 60% respectively) with overall mean of 58%. 10 association of hypertension was 6-50% in COPD patients. ...
Acute exacerbation of COPD is managed with oxygen therapy,
bronchodilators, systemic steroids, antibiotics and as needed Non
(NIV) and/or invasive mechanical ventilation. NIV reduces rates of intubation, mortality,
complications and duration of hospital stay.
... This is similar to the previous studies by Watz et al. [8] which showed hypertension to be highly prevalent in COPD patients (70%) and Mannino et al. [15] found that frequency of hypertension in COPD patients was 55%. Fumagalli et al. [16] also demonstrated a 53% incidence of hypertension. In our study central obesity had comparatively lower prevalence (24%) which may be due to low socioeconomic status and under nutrition seen in this locality [17]. ...
study of metabolic syndrome in COPD and its implications
... The prevalence of comorbidities varied from study to study. In a study by Fumagalli et al. reported that 94.1% of the patients had comorbidities [10]. Sin DD et al. reported a prevalence of 66.67% comorbidities in their patient sample [11]. ...
... Subjects with comorbidities in our study were found to have higher and statistically significant hospitalizations in a year (p < 0.001). The study by Fumagalli G et al. reported that patients with comorbidities had frequent readmissions and a longer stay at the hospital [10]. Holguin F et al. in their retrospective study involving COPD patients from 1979 to 2001 in the USA has noted that a large proportion of patients admitted to the hospitals for comorbid conditions [12]. ...
Introduction: COPD is an obstructive airway disease with significant systemic comorbidities that affect hospitalization and the overall severity of the disease. The aim of the study was to assess the prevalence of comorbidities and their effect on the hospitalization of COPD patients.
Methods: The study was a cross-sectional study conducted in 2013 among patients of a tertiary care hospital. The sample size was 106. Inclusion criteria were diagnosed patients of COPD according to GOLD criteria. Patients were diagnosed with COPD based on GOLD criteria guidelines and evaluated for various comorbidities based on presenting complaints. Variables collected were the number and kind of diagnosed comorbidities, the average number of hospitalizations per year. The prevalence of each comorbidity was found out and the chi-square test (p < 0.05) was used to find out the correlation between hospitalization and comorbidities.
Results: Of 106 participants, 63.2% had at least 1 comorbidity. 37.73% had 2–4 comorbidities. Prevalence of diabetes mellitus was 35.8%, systemic hypertension was diagnosed in 47% of the subjects. 5.7% had left heart abnormalities, 4.7% had ischemic heart disease (IHD), and 16% had pulmonary arterial hypertension. 43.4% had gastroesophageal reflux disease and gastric ulceration, 38.6% had metabolic syndrome and 8.5% had obstructive sleep apnea, 8% had psychiatric disorders, 7.5% had osteoporosis, and 1.9% were diagnosed with lung malignancy. There was a significant association between mean hospitalizations and the presence of comorbidities (p < 0.05). Hospitalizations were majorly due to exacerbation of COPD.
Conclusion: Prevalence of comorbid conditions among COPD patients are concluded to be high with an adverse effect on the average number of hospitalizations per year.
... Furthermore, metabolic disorders, especially diabetes that generally manifested with obesity, are associated with a substantial loss of pulmonary function in a restrictive pattern. [8,9] Oxidative stress, non-enzymatic glycation of proteins, and the polyol pathway have been recognized to be elaborated in the etiology of diabetic lung injury. [10] The findings of the PFTs in Type 2 DM could guide the clinicians to modify the intervention and management strategies. ...
Background: Association of diabetes with abnormal lung function was suggested by several studies. Reduced elastic recoil, reduced lung volume, diminished respiratory muscle performance, chronic low-grade inflammation, decrease in pulmonary diffusion capacity for carbon monoxide, and autonomic neuropathy involving respiratory muscles are some of the important changes occurring in diabetes mellitus (DM). Furthermore, metabolic disorders, especially diabetes that generally manifested with obesity, are associated with a substantial loss of pulmonary function in a restrictive pattern. Aims and Objectives: The findings of the pulmonary function tests (PFTs) in Type 2 DM could guide the clinicians to modify the intervention and management strategies. The present study relates duration of diabetes and glycosylated hemoglobin (HbA1c) to lung function parameters among the Type 2 DM patients. It also compares the glycemic indices and lung function parameters of diabetics with those of the non-diabetics to reaffirm the results. Materials and Methods: Glycemic indices and lung parameters are measured among diabetics and control non-diabetics. Results: We found no effect of duration of diabetes on the mean values of the lung function parameters. All the lung function parameters showed negative correlation with HbA1c, especially for forced expiratory volume in 1 s (FEV1%) suggesting a decline in FEV1% with an increase in HbA1c. On comparing lung function parameters between diabetics and non-diabetics, we found statistically significant reduction in forced vital capacity, FEV1, peak expiratory flow rate, and forced expiratory flow 25-75 associated with an increase in FEV1% in both male and female diabetics which points to a restrictive type of pulmonary dysfunction. Conclusions: Our study revealed restrictive pattern of lung function impairment in persons suffering from diabetes of both sexes. PFT can be used as a screening method to detect early changes in lung parameters in persons suffering from DM so as to prevent further restriction in functioning of respiratory system.
