Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) Comorbidities in Lithuanian National Database: A Cluster
Elena Jurevičienė1,2, Greta Burneikaitė1,2, Laimis Dambrauskas1,2
1Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania.
Insights
Chronic obstructive pulmonary disease (COPD) significantly increases the risk of lung cancer, heart failure, and cardiovascular diseases. Understanding these comorbidity patterns is crucial for better patient management and improved health outcomes.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Health Services Research
Background:
- Chronic obstructive pulmonary disease (COPD) is frequently associated with various comorbidities and multimorbidity.
- These conditions strain healthcare systems and increase patient mortality.
- The impact of COPD on comorbidity patterns requires thorough investigation.
Purpose of the Study:
- To assess the influence of COPD on the probability and clustering of comorbidities.
- To identify specific disease associations in patients with COPD.
- To analyze differences in comorbidity patterns between sexes and in relation to COPD presence.
Main Methods:
- Cross-sectional analysis of a nationwide Lithuanian database.
- Utilized diagnostic codes for chronic diseases, including COPD (J44.8) and bronchodilator use.
- Employed descriptive statistics, odds ratios (ORs), and agglomerative hierarchical clustering.
Main Results:
- Included 321,297 patients (4834 with COPD).
- COPD associated with significantly higher odds of lung cancer (OR 6.66), heart failure (OR 2.61), and cardiovascular diseases (CVD) (OR 1.83).
- Identified distinct comorbidity clusters, with variations based on sex and COPD status; cardiovascular cluster prevalence was similar, but dyslipidemia linkage differed.
Conclusions:
- COPD significantly elevates the risk for major comorbidities like lung cancer, heart failure, and CVD.
- Comorbidity clustering differs between sexes and in individuals with and without COPD.
- There is a need for tailored multimorbidity management and screening strategies for COPD patients to improve outcomes.
Abstract:
Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40-79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD-five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.
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