Association Between Chronic Obstructive Pulmonary Disease and Mortality in Participants with Arthritis: Data from the National Health and Nutrition Examination Survey 1999-2018.

Abstract

Objective: Chronic obstructive pulmonary disease (COPD) is closely associated with arthritis. This study aims to evaluate the correlation between COPD and mortality among participants with arthritis.

Methods: The study included 11,298 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, who self-reported having arthritis. Cox proportional hazard models were used to assess the association between COPD and mortality among participants with arthritis. Kaplan-Meier survival curves were plotted to compare survival probabilities between groups. Subgroup and sensitivity analyses were conducted to assess the robustness of the results.

Results: During an average follow-up of 8.8 years, 3061 all-cause deaths were observed, including 1024 related to cardiovascular disease (CVD). After weighted multivariable adjustment, COPD was found to be significantly associated with both all-cause and CVD mortality among these arthritis participants. The hazard ratio (HR) for all-cause mortality among arthritis patients with COPD was 1.41 (95% confidence interval [CI]: 1.25-1.60, p < 0.001), and the HR for CVD mortality was 1.29 (95% CI: 1.08-1.53, p < 0.001). Kaplan-Meier survival curves attributed higher rates of both all-cause and CVD mortality among participants with COPD compared to those without (log-rank test, p < 0.001). Additionally, COPD increased the risk of both chronic lower respiratory disease (CLRD) mortality (HR 5.46, 95% CI: 3.48-8.56, p < 0.001) and non-CLRD mortality (HR 1.24, 95% CI: 1.07-1.44, p=0.004).

Conclusion: In the American population, arthritis patients with COPD have higher risks of all-cause and CVD mortality compared to those without COPD.