与非COPD对照相比,COPD患者的合并症和死亡原因:一项8年观察性回顾性医疗索赔数据库队列研究

IF 3.1 3区 医学 Q2 RESPIRATORY SYSTEM
Claus F Vogelmeier, Felix W Friedrich, Patrick Timpel, Nils Kossack, Joanna Diesing, Marc Pignot, Melanie Abram, Michael Gediga, Marija Halbach
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引用次数: 0

摘要

目的:慢性阻塞性肺病患者患有各种合并症,似乎导致发病率和死亡率的集体增加。然而,慢性阻塞性肺病的合并症在很大程度上没有报道。患者和方法:使用医疗索赔数据,在长达8年的时间里,仅对2011-2018年诊断的约25万名COPD患者中的死者进行死因(无竞争风险的累积发病率)评估。结果与1:1倾向评分匹配对照进行比较。此外,还比较了死亡患者合并症的患病率。结果:死亡的COPD患者和对照组的平均寿命分别为75.7岁和78.0岁,COPD患者在死亡前有更多的合并症(平均为4.53岁和3.65岁)。与对照组相比,COPD患者呼吸系统和心血管相关死亡的可能性更高(8年后分别高出3.3和1.6个百分点),并且在多次/严重恶化的COPD亚组中更为极端(分别高出9.8和3.4个百分点);累积死亡率随COPD严重程度的增加而增加。COPD患者的合并症患病率,特别是心血管相关的患病率高于匹配对照组;COPD患者发生心力衰竭的风险高出42% (RR 1.42;1.38-1.47),缺血性心脏病风险增加30% (RR 1.30;1.25-1.35),房颤风险增加27% (RR 1.27;1.21 - -1.32)。结论:在这项现实世界的观察性回顾性队列研究中,我们发现COPD患者的死亡年龄更小,并且与对照组相比出现了更多的合并症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study.

Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study.

Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study.

Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study.

Purpose: Patients with COPD suffer from various comorbidities, seemingly leading to a collective increase in morbidity and mortality. However, comorbidities with COPD have been largely unreported.

Patients and methods: Using healthcare claims data, only the deceased among around 250,000 COPD patients diagnosed in 2011-2018 were evaluated by cause of death (cumulative incidence without competing risk) across a period of up to eight years. Results were compared with 1:1 propensity score-matched controls. Additionally, the prevalence of comorbidities in deceased patients was compared.

Results: On average, deceased COPD patients and matched controls lived to be 75.7 and 78.0 years, respectively, and COPD patients had more comorbidities prior to death (mean 4.53 and 3.65). Both respiratory and cardiovascular-related deaths were more likely in COPD patients than in their matched controls (3.3 and 1.6 percentage points higher after eight years), and this was more extreme (9.8 and 3.4 percentage points higher, respectively) in the COPD subgroup with multiple/severe exacerbations; cumulative incidence of death increased with increasing COPD severity. Comorbidity prevalence, especially cardiovascular-related, was higher in COPD patients than in matched controls; COPD patients had a 42% higher risk of heart failure (RR 1.42; 1.38-1.47), 30% higher risk of ischemic heart disease (RR 1.30; 1.25-1.35), and 27% increased risk of atrial fibrillation (RR 1.27; 1.21-1.32).

Conclusion: In this real-world observational retrospective cohort study, we found patients with COPD died at a younger age, and developed more comorbidities, than matched controls.

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来源期刊
CiteScore
4.80
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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