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Prognostic influence of cardiac comorbidities in chronic obstructive pulmonary disease
Tara Pereiro Brea1, Carlos Zamarrón Sanz1, Óscar Lado-Baleato2
1Servicio de Neumología. Hospital Clínico-Universitario de Santiago. Santiago de Compostela, Spain.
Insights
Patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) face worse outcomes and higher healthcare use. Managing these combined conditions is crucial for better patient prognosis and efficient resource allocation.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) frequently co-occurs with cardiovascular diseases (CVD).
- These comorbidities can negatively impact patient prognosis and healthcare utilization.
- Understanding the combined burden of COPD and CVD is essential for effective patient management.
Purpose of the Study:
- To determine if patients with COPD and coexisting CVD experience increased healthcare resource utilization.
- To investigate whether COPD patients with CVD face higher hospitalization rates and mortality.
- To compare outcomes of COPD patients with and without cardiovascular comorbidities.
Main Methods:
- A population-based study involving 7391 patients with COPD.
- Patients were categorized into four groups based on the presence of heart failure (HF) and ischemic heart disease (IHD).
- Statistical analyses included adjusted logistic regression and proportional hazards models.
Main Results:
- The prevalence of COPD alone was 86.3%, COPD+HF was 8.1%, COPD+IHD was 3.9%, and COPD+HF+IHD was 1.7%.
- Patients with COPD and CVD were older, had higher cardiovascular risk, and experienced increased mortality.
- Hospitalization was linked to older age, male sex, reduced primary care spirometry, home oxygen use, non-invasive ventilation, and higher mortality.
Conclusions:
- The coexistence of COPD and CVD identifies patient subgroups with poorer prognosis and elevated healthcare resource utilization.
- Multidisciplinary management approaches are vital for improving outcomes in these patients.
- Implementing targeted prevention strategies can enhance both patient prognosis and healthcare system efficiency.
Background:
Chronic obstructive pulmonary disease (COPD) is frequently associated with cardiovascular diseases (CVD), which may adversely affect the prognosis of these patients.
Objective:
To confirm that individuals with COPD and CVD utilize more healthcare resources, require more frequent hospitalizations, and have higher mortality rates compared to those without these comorbidities.
Methods:
Population-based study including 7391 COPD patients, classified into four groups according to the presence of heart failure (HF) and ischemic heart disease (IHD). Adjusted logistic regression and proportional hazards models were performed.
Results:
Of the patients, 86.3 % (6378) had COPD alone; 8.1 % (601) had COPD + HF; 3.9 % (290) had COPD + IHD; and 1.7 % (122) had all three conditions. Groups with CVD exhibited older age, higher cardiovascular risk, and increased mortality. Hospitalization was associated with older age, male sex, fewer spirometry tests performed in primary care, and the use of home oxygen therapy and non-invasive ventilation, and was linked to higher mortality compared to non-hospitalized patients. Mortality was higher among patients with COPD and CVD. It was associated with more emergency department visits, more hospital admissions, increased use of chest X-rays and CT scans, and a higher prevalence of depression. Conversely, it was also related to lower rates of vaccination, fewer spirometry tests in primary care, reduced dispensing of inhaled medications, and overall lower pharmaceutical expenditure.
Conclusion:
The coexistence of COPD and CVD identifies subgroups of patients with poorer prognosis and increased healthcare resource utilization. Multidisciplinary management and prevention strategies are essential to improve outcomes and healthcare efficiency.
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