Bozek Andrzej, Rogala Barbara, Bednarski Piotr
a Clinical Department of Internal Disease , Allergology and Dermatology in Zabrze, Medical University of Silesia , Katowice , Poland.
b Clinical Department of Internal Disease , Allergology and Immunology, Medical University of Silesia , Katowice , Poland.
J Asthma. 2016 Nov;53(9):943-7. doi: 10.3109/02770903.2016.1170139. Epub 2016 Apr 26.
Co-morbidities are a significant problem in the elderly population but are rarely presented and analyzed for interdependencies among the various coexisting chronic diseases.
The aim of this study was to present a profile of comorbidities in elderly patients with and without asthma and COPD.
Respondents were recruited at 20 sites in Poland. Stratified random sampling from patient databases resulted in 15,973 patients older than 60 years of age. A retrospective analysis of medical history and ICD-10 codes was performed. In addition, patients underwent a spirometry test with a bronchial reversibility test and were administered questionnaires on the prevalence of chronic diseases by doctors.
The study population consisted of 1023 asthmatic patients, 1084 patients with COPD and 1076 control subjects without any signs of bronchoconstriction and with correct spirometry. Patients with asthma exhibited a similar distribution of cardiovascular and metabolic co-morbidities as the control group. However, asthmatic patients had a higher prevalence of arterial hypertension and depression with an odds ratio (OR) = 1.48 (95% CI: 1.38-1.62) and OR = 1.52 (95% CI: 1.44-1.68), respectively. Coronary disease (OR = 2.12; 95% CI: 1.97-2.33), cor pulmonale (OR = 3.1; 95% CI: 2.87-3.22) and heart failure (OR = 2.71; 95% CI: 2.64-3.11) were predominantly observed in patients with COPD. Patients with severe asthma exhibited a greater predisposition to cardiovascular and neuropsychiatric diseases.
Asthma coexisted frequently with arterial hypertension and depression in elderly patients. Patients with COPD have a more exaggerated profile of coexisting diseases, specifically cardiovascular problems.
共病在老年人群中是一个重大问题,但很少有人对各种并存的慢性病之间的相互依存关系进行呈现和分析。
本研究的目的是呈现患有和未患有哮喘及慢性阻塞性肺疾病(COPD)的老年患者的共病情况。
在波兰的20个地点招募受访者。从患者数据库中进行分层随机抽样,得到15973名60岁以上的患者。对病史和国际疾病分类第十版(ICD - 10)编码进行回顾性分析。此外,患者接受了肺活量测定测试及支气管可逆性测试,并由医生发放关于慢性病患病率的问卷。
研究人群包括1023名哮喘患者、1084名COPD患者和1076名无任何支气管收缩迹象且肺活量测定结果正常的对照受试者。哮喘患者心血管和代谢共病的分布与对照组相似。然而,哮喘患者动脉高血压和抑郁症的患病率较高,优势比(OR)分别为1.48(95%置信区间:1.38 - 1.62)和1.52(95%置信区间:1.44 - 1.68)。冠心病(OR = 2.12;95%置信区间:1.97 - 2.33)、肺心病(OR = 3.1;95%置信区间:2.87 - 3.22)和心力衰竭(OR = 2.71;95%置信区间:2.64 - 3.11)主要在COPD患者中观察到。重度哮喘患者更容易患心血管和神经精神疾病。
老年患者中哮喘常与动脉高血压和抑郁症并存。COPD患者并存疾病的情况更为严重,尤其是心血管问题。