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Treatment intensity level as a proxy for severity of chronic obstructive pulmonary disease: A risk stratification tool.
Lauridsen, Marie Dam; Grøntved, Simon; Fosbøl, Emil; Johnsen, Søren P; Quint, Jennifer K; Weinreich, Ulla Møller; Valentin, Jan Brink.
Afiliación
  • Lauridsen MD; Department of Respiratory Diseases, Respiratory Research Aalborg, Aalborg University Hospital, Aalborg, Denmark; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital
  • Grøntved S; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Region North Psychiatry, Aalborg, Denmark.
  • Fosbøl E; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
  • Johnsen SP; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Quint JK; School of Public Health, Imperial College London, London, UK.
  • Weinreich UM; Department of Respiratory Diseases, Respiratory Research Aalborg, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Valentin JB; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Respir Med ; 232: 107742, 2024 10.
Article en En | MEDLINE | ID: mdl-39094793
ABSTRACT

BACKGROUND:

Increasing severity of chronic obstructive pulmonary disease (COPD) is associated with increasing risk of poor outcomes. Using health registry data, we aimed to assess the association between treatment intensity levels (TIL), as a proxy for underlying COPD severity, and long-term outcomes.

METHODS:

Using Danish nationwide registries, we identified patients diagnosed with COPD during 2001-2016, who were alive at index date of 1 January 2017. We stratified patients into exclusive TILs from least to most severe no use, short term therapy, mono-, dual-, triple therapy, oral corticosteroid (OCS), and long-term oxygen treatment (LTOT). Survival analyses were used to assess 5-year outcomes by TIL.

RESULTS:

We identified 53,803 patients with COPD in the study period (median age 72 years [inter quartile range, 64-80], 48 % male). The three most severe TILs were associated with a significant incremental increase in all-cause mortality with an adjusted hazard ratio (aHR) for triple therapy, OCS and LTOT of 1.44 (95 % CI 1.38-1.51), 1.67 (95 % CI 1.59-1.75), and 2.91 (95 % CI 2.76-3.07) compared with those receiving no therapy as reference. The same pattern was evident for the composite outcome of 5-year mortality or COPD-related hospitalization with an aHR for triple therapy, OCS and LTOT of 2.30 (95 % CI 2.22-2.38), 2.85 (95 % CI 2.74-2.96), and 4.00 (95 % CI 3.81-4.20), respectively.

CONCLUSION:

Increasing TILs were associated with increasing five-year mortality and risk of COPD-related hospitalization. TILs may be used as a proxy for underlying COPD severity in epidemiological studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Sistema de Registros / Enfermedad Pulmonar Obstructiva Crónica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Sistema de Registros / Enfermedad Pulmonar Obstructiva Crónica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido