Recognising heart failure in elderly patients with stable chronic obstructive pulmonary disease in primary care: Cross sectional diagnostic study

BackgroundChronic obstructive pulmonary disease (COPD) is common, and a major cause of morbidity and mortality worldwide. Recent studies suggest that comorbidities of COPD increase the risk of hospitalisation, polypharmacy, and mortality, but their estimated prevalence varies widely in the literature.AimTo evaluate the prevalence of 38 physical and mental health comorbidities in people with COPD, and compare findings with those for people without COPD in a large nationally representative dataset.Design and settingA cross-sectional data analysis on 1 272 685 adults in Scotland from 314 primary care practices.MethodData on COPD, along with 31 physical and seven mental health comorbidities, were extracted. The prevalence of comorbidities was compared between people who did, and did not, have COPD, standardised by age, sex, and socioeconomic deprivation.ResultsFrom the total sample, 51 928 patients had COPD (4.1%). Of these, 86.0% had at least one comorbidity, compared with 48.9% of people without COPD. Of those with COPD, 22.3% had ≥5 comorbid conditions compared with 4.9% of those who did not have COPD (adjusted odds ratio 2.63, 95% confidence interval = 2.56 to 2.70). In total, 29 of the 31 physical conditions and six of the seven mental health conditions were statistically significantly more prevalent in people who had COPD than those who did not.ConclusionPatients with COPD have extensive associated comorbidities. There is a real need for guidelines and health care to reflect this complexity, including how to detect those common comorbidities that relate to both physical and mental health, and how best to manage them. Primary care, which is unique in terms of offering expert generalist care, is best placed to provide this integrated approach.

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Iron deficiency in non-anemic chronic obstructive pulmonary disease in a predominantly male population: an ignored entity

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1126 ◽

2020 ◽

Vol 90 (1) ◽

Cited By ~ 1

Author(s):

Vidushi Rathi ◽

Pranav Ish ◽

Gulvir Singh ◽

Mani Tiwari ◽

Nitin Goel ◽

...

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Iron Deficiency ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Male Population ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Iron Deficient ◽

Significant Difference

Non-anemic iron deficiency has been studied in heart failure, but studies are lacking in chronic obstructive pulmonary disease (COPD). The potential clinical implications of association of iron deficiency with the severity of COPD warrant research in this direction. This was an observational, cross-sectional study on patients with COPD to compare disease severity, functional status and quality of life in non-anemic patients with COPD between two groups - iron deficient and non-iron deficient. Stable non-anemic COPD with no cause of bleeding were evaluated for serum iron levels, ferritin levels, TIBC, 6MWD, SGRQ, spirometry, and CAT questionnaire. The study patients were divided into iron replete (IR) and iron deficient (ID) groups. A total of 79 patients were studied, out of which 72 were men and seven were women. The mean age was 61.5±8.42 years. Of these, 36 (45.5%; 95% CI, 34.3-56.8%) had iron deficiency. Mean 6-minute-walk distance was significantly shorter in ID (354.28±82.4 meters vs 432.5±47.21 meters; p=0.001). A number of exacerbations in a year were more in ID group (p=0.003), and more patients in ID had at least two exacerbations of COPD within a year (p=0.001). However, the resting pO2, SaO2, and SpO2 levels did not differ significantly between the two groups (p=0.15 and p=0.52, respectively). Also, there was no significant difference in the distribution of patients of a different class of airflow limitations between the two groups. Non-anemic iron deficiency (NAID) is an ignored, yet easily correctable comorbidity in COPD. Patients with iron deficiency have a more severe grade of COPD, had lesser exercise capacity and more exacerbations in a year as compared to non-iron deficient patients. So, foraying into the avenue of iron supplementation, which has shown promising results in improving functional capacity in heart failure and pulmonary hypertension, may well lead to revolutionary changes in the treatment of COPD.

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Implication of chronic obstructive pulmonary disease in elderly patients with stable chronic heart failure – It is ignored combination

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(08)60054-5 ◽

2008 ◽

Vol 7 ◽

pp. 19-20

Author(s):

S APOSTOLOVIC ◽

H DUNGEN ◽

R JANKOVIC ◽

D DJORDJEVIC ◽

S SALINGERMARTINOVIC ◽

...

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Chronic Heart Failure ◽

Elderly Patients ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Occurrence and impact of chronic obstructive pulmonary disease in elderly patients with stable heart failure

Respirology ◽

10.1111/j.1440-1843.2012.02264.x ◽

2012 ◽

Vol 18 (1) ◽

pp. 125-130 ◽

Cited By ~ 22

Author(s):

PIERA BOSCHETTO ◽

ALESSANDRO FUCILI ◽

MARIARITA STENDARDO ◽

MICHELE MALAGÙ ◽

GIOVANNI PARRINELLO ◽

...

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Elderly Patients ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Comparison of B-type natriuretic peptide assays for identifying heart failure in stable elderly patients with a clinical diagnosis of chronic obstructive pulmonary disease

European Journal of Heart Failure ◽

10.1016/j.ejheart.2007.01.010 ◽

2007 ◽

Vol 9 (6-7) ◽

pp. 651-659 ◽

Cited By ~ 57

Author(s):

Frans H. Rutten ◽

Maarten-Jan M. Cramer ◽

Nicolaas P.A. Zuithoff ◽

Jan-Willem J. Lammers ◽

Wim Verweij ◽

...

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Elderly Patients ◽

Pulmonary Disease ◽

Natriuretic Peptide ◽

Clinical Diagnosis ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

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Clinico-epidemiological characteristics of men and women with a new diagnosis of chronic obstructive pulmonary disease: a database (SIDIAP) study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01392-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Josep Montserrat-Capdevila ◽

Josep Ramon Marsal ◽

Marta Ortega ◽

Maria Teresa Castañ-Abad ◽

Miquel Alsedà ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Primary Care ◽

Pulmonary Disease ◽

Cor Pulmonale ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Men And Women ◽

Epidemiological Characteristics ◽

Strength Of Association

Abstract Background The risk of developing Chronic Obstructive Pulmonary Disease (COPD), the associated comorbidities and response to bronchodilators might differ in men and women. The objective of this study was to determine the prevalence of COPD and the clinic-epidemiological characteristics of primary care patients with COPD according to gender. Methods This is a cross-sectional study using electronic healthcare records Catalonia (Spain), during the 01/01/2012–31/12/2017 period. Patients from the SIDIAP database (System for the Development of Research in Primary Care) were included (5,800,000 patients registered in 279 primary care health centres). Clinic-demographic characteristics, comorbidities and blood tests results were collected for each patient. Adjusted OR (ORa) with logistic regression methods were used to determine variables associated with men and women. Results From an initial sample of 800,899 people, 24,135 (3%) were considered COPD patients, and 22.9%were women. The most common risk factors in women were bronchiectasis (ORa = 20.5, SD = 19.5–21.6), age > 71 years (ORa = 18.8; SD = 17.3–20.5), cor pulmonale (ORa = 5.2; SD = 4.3–6.7) and lung cancer (ORa = 3.6, SD = 3.2–4.0). Men and women presented the same comorbidities, though the strength of association was different for each gender. Conclusions Patients suffering high comorbidity rates. Comorbidities are similar in men and women, although the strength of association varies according to gender. Women are more susceptible to the harmful effects of smoking and present a higher proportion of bronchiectasis and OSAS.

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