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

doi:10.2147/COPD.S95954

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

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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 language	English
Pages (from-to)	775-783
Number of pages	9
Journal	International journal of chronic obstructive pulmonary disease
Volume	11
Issue number	1
DOIs	https://doi.org/10.2147/COPD.S95954
Publication status	Published - 15 Apr 2016

Bibliographical 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.

Keywords

bronchial asthma
chronic obstructive pulmonary disease
acute exacerbation

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Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database
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Cite this

Lee, H., Rhee, C. K., Lee, B-J., Choi, D-C., Kim, J-A., Kim, S. H., Jeong, Y., Kim, T-H., Chon, G. R., Jung, K-S., Lee, S. H., Price, D., Yoo, K. H., & Park, H. Y. (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 , 11(1), 775-783. https://doi.org/10.2147/COPD.S95954

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

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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{\textquoteright}s abstract was published in “Poster Abstracts” in Respirology.",

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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

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DO - 10.2147/COPD.S95954

M3 - Article

C2 - 27143869

SN - 1176-9106

VL - 11

SP - 775

EP - 783

JO - International journal of chronic obstructive pulmonary disease

JF - International journal of chronic obstructive pulmonary disease

IS - 1

ER -

Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD: results from a national database

Abstract

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