Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update (GEDA) 2009 and 2010.
Henriette Steppuhn, Ute Langen, Thomas Keil, Christa Scheidt-Nave
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引用次数: 42
Abstract
Background: Co-morbidities may complicate the clinical management of chronic conditions such as asthma.
Aims: To quantify the strength of the relationship between asthma and other chronic diseases and to analyse whether co-morbidities contribute to unscheduled asthma care.
Methods: Data from two consecutive national telephone health interview surveys (GEDA 2009 and 2010) including a total of 43,312 adults (>18 years of age) were analysed. Persons with and without a current diagnosis of asthma were compared with respect to concurrent diagnoses (diabetes mellitus, hypertension, chronic heart failure, depression, osteoarthritis, stroke, coronary heart disease, and cancer). Logistic regression models were applied to assess the strength of the association between asthma and co-morbidities in the total study population and, among persons with asthma, between the number of co-morbidities and unscheduled inpatient (hospital admissions and/or emergency department admissions) or outpatient asthma care in the past 12 months.
Results: Overall, 5.3% (95% CI 5.0% to 5.6%) of adults reported current physician-diagnosed asthma. Asthma was significantly associated with most of the conditions considered and 18% of persons with asthma had three or more co-morbidities. Adjusted odds ratios (AOR) of unscheduled asthma care increased with numbers of conditions, with AOR 3.40 (95% CI 1.39 to 8.31) for unscheduled inpatient care and AOR 2.32 (95% CI 1.30 to 4.14) for unscheduled outpatient care comparing those with three or more co-morbidities versus those with none.
Conclusions: The magnitude of chronic disease co-morbidity is substantial in asthma, is related to unscheduled asthma care, and implies a significant number of adults with asthma facing complex healthcare needs.
背景:合并症可能使慢性疾病如哮喘的临床管理复杂化。目的:量化哮喘与其他慢性疾病之间的关系强度,并分析合并症是否有助于计划外哮喘护理。方法:分析两次连续的全国电话健康访谈调查(2009年和2010年)的数据,其中包括43,312名成年人(>18岁)。目前诊断为哮喘和未诊断为哮喘的人在并发诊断(糖尿病、高血压、慢性心力衰竭、抑郁症、骨关节炎、中风、冠心病和癌症)方面进行比较。应用Logistic回归模型评估总体研究人群中哮喘与合并症之间的关联强度,以及哮喘患者中合并症数量与过去12个月内未计划住院(住院和/或急诊住院)或门诊哮喘护理之间的关联强度。结果:总体而言,5.3% (95% CI 5.0%至5.6%)的成年人报告目前有医生诊断的哮喘。哮喘与所考虑的大多数疾病显著相关,18%的哮喘患者有三种或更多的合并症。非计划哮喘治疗的调整优势比(AOR)随着疾病数量的增加而增加,非计划住院治疗的调整优势比为3.40 (95% CI 1.39 ~ 8.31),非计划门诊治疗的调整优势比为2.32 (95% CI 1.30 ~ 4.14),与有三种或更多合并症的患者相比,无计划门诊治疗的调整优势比为2.32 (95% CI 1.30 ~ 4.14)。结论:哮喘慢性疾病合并症的严重程度是相当可观的,与计划外的哮喘护理有关,这意味着有相当数量的成人哮喘患者面临复杂的医疗保健需求。