Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD

results from a national database

Hyun Lee, Chin Kook Rhee, Byung-Jae Lee, Dong-Chull Choi, Jee-Ae Kim, Sang Hyun Kim, Yoolwon Jeong, Tae-Hyung Kim, Gyu Rak Chon, Ki-Suck Jung, Sang Haak Lee, David Price, Kwang Ha Yoo, Hye Yun Park

Research output: Contribution to journalArticle

5 Citations (Scopus)
3 Downloads (Pure)

Abstract

BACKGROUND: Acute exacerbations are major drivers of COPD deterioration. However, limited data are available for the prevalence of severe exacerbations and impact of asthma on severe exacerbations, especially in patients with mild-to-moderate COPD.

METHODS: Patients with mild-to-moderate COPD (≥40 years) were extracted from Korean National Health and Nutrition Examination Survey data (2007-2012) and were linked to the national health insurance reimbursement database to obtain medical service utilization records.

RESULTS: Of the 2,397 patients with mild-to-moderate COPD, 111 (4.6%) had severe exacerbations over the 6 years (0.012/person-year). Severe exacerbations were more frequent in the COPD patients with concomitant self-reported physician-diagnosed asthma compared with only COPD patients (P<0.001). A multiple logistic regression presented that asthma was an independent risk factor of severe exacerbations in patients with mild-to-moderate COPD regardless of adjustment for all possible confounding factors (adjusted odds ratio, 1.67; 95% confidence interval, 1.002-2.77, P=0.049). In addition, age, female, poor lung function, use of inhalers, and low EuroQoL five dimensions questionnaire index values were independently associated with severe exacerbation in patients with mild-to-moderate COPD.

CONCLUSION: In this population-based study, the prevalence of severe exacerbations in patients with mild-to-moderate COPD was relatively low, compared with previous clinical interventional studies. Coexisting asthma significantly impacted the frequency of severe exacerbations in patients with mild-to-moderate COPD, suggesting application of an exacerbation preventive strategy in these patients.

Original languageEnglish
Pages (from-to)775-783
Number of pages9
JournalInternational journal of chronic obstructive pulmonary disease
Volume11
Issue number1
DOIs
Publication statusPublished - 15 Apr 2016

Fingerprint

Chronic Obstructive Pulmonary Disease
Asthma
Databases
Health Insurance Reimbursement
Nutrition Surveys
Nebulizers and Vaporizers
National Health Programs
Cross-Sectional Studies
Logistic Models
Odds Ratio
Confidence Intervals
Physicians
Lung

Keywords

  • bronchial asthma
  • chronic obstructive pulmonary disease
  • acute exacerbation

Cite this

Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD : results from a national database. / Lee, Hyun; Rhee, Chin Kook; Lee, Byung-Jae; Choi, Dong-Chull; Kim, Jee-Ae; Kim, Sang Hyun; Jeong, Yoolwon; Kim, Tae-Hyung; Chon, Gyu Rak; Jung, Ki-Suck; Lee, Sang Haak; Price, David; Yoo, Kwang Ha; Park, Hye Yun.

In: International journal of chronic obstructive pulmonary disease , Vol. 11, No. 1, 15.04.2016, p. 775-783.

Research output: Contribution to journalArticle

Lee, H, Rhee, CK, Lee, B-J, Choi, D-C, Kim, J-A, Kim, SH, Jeong, Y, Kim, T-H, Chon, GR, Jung, K-S, Lee, SH, Price, D, Yoo, KH & Park, HY 2016, 'Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database', International journal of chronic obstructive pulmonary disease , vol. 11, no. 1, pp. 775-783. https://doi.org/10.2147/COPD.S95954
Lee, Hyun ; Rhee, Chin Kook ; Lee, Byung-Jae ; Choi, Dong-Chull ; Kim, Jee-Ae ; Kim, Sang Hyun ; Jeong, Yoolwon ; Kim, Tae-Hyung ; Chon, Gyu Rak ; Jung, Ki-Suck ; Lee, Sang Haak ; Price, David ; Yoo, Kwang Ha ; Park, Hye Yun. / Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD : results from a national database. In: International journal of chronic obstructive pulmonary disease . 2016 ; Vol. 11, No. 1. pp. 775-783.
@article{c4cf309102434ee3bdfb7eb1dc5ee346,
title = "Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database",
abstract = "BACKGROUND: Acute exacerbations are major drivers of COPD deterioration. However, limited data are available for the prevalence of severe exacerbations and impact of asthma on severe exacerbations, especially in patients with mild-to-moderate COPD.METHODS: Patients with mild-to-moderate COPD (≥40 years) were extracted from Korean National Health and Nutrition Examination Survey data (2007-2012) and were linked to the national health insurance reimbursement database to obtain medical service utilization records.RESULTS: Of the 2,397 patients with mild-to-moderate COPD, 111 (4.6{\%}) had severe exacerbations over the 6 years (0.012/person-year). Severe exacerbations were more frequent in the COPD patients with concomitant self-reported physician-diagnosed asthma compared with only COPD patients (P<0.001). A multiple logistic regression presented that asthma was an independent risk factor of severe exacerbations in patients with mild-to-moderate COPD regardless of adjustment for all possible confounding factors (adjusted odds ratio, 1.67; 95{\%} confidence interval, 1.002-2.77, P=0.049). In addition, age, female, poor lung function, use of inhalers, and low EuroQoL five dimensions questionnaire index values were independently associated with severe exacerbation in patients with mild-to-moderate COPD.CONCLUSION: In this population-based study, the prevalence of severe exacerbations in patients with mild-to-moderate COPD was relatively low, compared with previous clinical interventional studies. Coexisting asthma significantly impacted the frequency of severe exacerbations in patients with mild-to-moderate COPD, suggesting application of an exacerbation preventive strategy in these patients.",
keywords = "bronchial asthma, chronic obstructive pulmonary disease, acute exacerbation",
author = "Hyun Lee and Rhee, {Chin Kook} and Byung-Jae Lee and Dong-Chull Choi and Jee-Ae Kim and Kim, {Sang Hyun} and Yoolwon Jeong and Tae-Hyung Kim and Chon, {Gyu Rak} and Ki-Suck Jung and Lee, {Sang Haak} and David Price and Yoo, {Kwang Ha} and Park, {Hye Yun}",
note = "Acknowledgments The authors would like to thank Kyungjoo Kim for the confident statistical analyses in this work. This study was supported by a grant (2014P3300300) from the Korea Centers for Disease Control and Prevention. The abstract of this paper was presented at the Asian Pacific Society of Respirology 20th Congress as an oral presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Respirology.",
year = "2016",
month = "4",
day = "15",
doi = "10.2147/COPD.S95954",
language = "English",
volume = "11",
pages = "775--783",
journal = "International journal of chronic obstructive pulmonary disease",
issn = "1176-9106",
publisher = "Dove Medical Press Ltd.",
number = "1",

}

TY - JOUR

T1 - Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD

T2 - results from a national database

AU - Lee, Hyun

AU - Rhee, Chin Kook

AU - Lee, Byung-Jae

AU - Choi, Dong-Chull

AU - Kim, Jee-Ae

AU - Kim, Sang Hyun

AU - Jeong, Yoolwon

AU - Kim, Tae-Hyung

AU - Chon, Gyu Rak

AU - Jung, Ki-Suck

AU - Lee, Sang Haak

AU - Price, David

AU - Yoo, Kwang Ha

AU - Park, Hye Yun

N1 - Acknowledgments The authors would like to thank Kyungjoo Kim for the confident statistical analyses in this work. This study was supported by a grant (2014P3300300) from the Korea Centers for Disease Control and Prevention. The abstract of this paper was presented at the Asian Pacific Society of Respirology 20th Congress as an oral presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Respirology.

PY - 2016/4/15

Y1 - 2016/4/15

N2 - BACKGROUND: Acute exacerbations are major drivers of COPD deterioration. However, limited data are available for the prevalence of severe exacerbations and impact of asthma on severe exacerbations, especially in patients with mild-to-moderate COPD.METHODS: Patients with mild-to-moderate COPD (≥40 years) were extracted from Korean National Health and Nutrition Examination Survey data (2007-2012) and were linked to the national health insurance reimbursement database to obtain medical service utilization records.RESULTS: Of the 2,397 patients with mild-to-moderate COPD, 111 (4.6%) had severe exacerbations over the 6 years (0.012/person-year). Severe exacerbations were more frequent in the COPD patients with concomitant self-reported physician-diagnosed asthma compared with only COPD patients (P<0.001). A multiple logistic regression presented that asthma was an independent risk factor of severe exacerbations in patients with mild-to-moderate COPD regardless of adjustment for all possible confounding factors (adjusted odds ratio, 1.67; 95% confidence interval, 1.002-2.77, P=0.049). In addition, age, female, poor lung function, use of inhalers, and low EuroQoL five dimensions questionnaire index values were independently associated with severe exacerbation in patients with mild-to-moderate COPD.CONCLUSION: In this population-based study, the prevalence of severe exacerbations in patients with mild-to-moderate COPD was relatively low, compared with previous clinical interventional studies. Coexisting asthma significantly impacted the frequency of severe exacerbations in patients with mild-to-moderate COPD, suggesting application of an exacerbation preventive strategy in these patients.

AB - BACKGROUND: Acute exacerbations are major drivers of COPD deterioration. However, limited data are available for the prevalence of severe exacerbations and impact of asthma on severe exacerbations, especially in patients with mild-to-moderate COPD.METHODS: Patients with mild-to-moderate COPD (≥40 years) were extracted from Korean National Health and Nutrition Examination Survey data (2007-2012) and were linked to the national health insurance reimbursement database to obtain medical service utilization records.RESULTS: Of the 2,397 patients with mild-to-moderate COPD, 111 (4.6%) had severe exacerbations over the 6 years (0.012/person-year). Severe exacerbations were more frequent in the COPD patients with concomitant self-reported physician-diagnosed asthma compared with only COPD patients (P<0.001). A multiple logistic regression presented that asthma was an independent risk factor of severe exacerbations in patients with mild-to-moderate COPD regardless of adjustment for all possible confounding factors (adjusted odds ratio, 1.67; 95% confidence interval, 1.002-2.77, P=0.049). In addition, age, female, poor lung function, use of inhalers, and low EuroQoL five dimensions questionnaire index values were independently associated with severe exacerbation in patients with mild-to-moderate COPD.CONCLUSION: In this population-based study, the prevalence of severe exacerbations in patients with mild-to-moderate COPD was relatively low, compared with previous clinical interventional studies. Coexisting asthma significantly impacted the frequency of severe exacerbations in patients with mild-to-moderate COPD, suggesting application of an exacerbation preventive strategy in these patients.

KW - bronchial asthma

KW - chronic obstructive pulmonary disease

KW - acute exacerbation

U2 - 10.2147/COPD.S95954

DO - 10.2147/COPD.S95954

M3 - Article

VL - 11

SP - 775

EP - 783

JO - International journal of chronic obstructive pulmonary disease

JF - International journal of chronic obstructive pulmonary disease

SN - 1176-9106

IS - 1

ER -