Comorbidity profile of patients with concurrent diagnoses of asthma and COPD in Germany

Akmatov, Manas K.; Ermakova, Tatiana; Holstiege, Jakob; Steffen, Annika; Stillfried, Dominik von; Bätzing, Jörg

doi:10.1038/s41598-020-74966-1

Cited by 28 publications

(15 citation statements)

References 35 publications

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“…Those in profiles 1 and 3 might also benefit from dietary counselling and calorie restriction plus resistance exercise training [ 38 , 39 ] and referral for comorbidities’ management [ 40 ], due to their high BMI and severity of comorbidities. Indeed, different body composition and comorbidity profiles which involve several body systems in people with COPD have been acknowledged and multidisciplinary care approaches advocated [ 7 , 41 ]. People in profile 2 showed the worst emotional status.…”

Section: Discussionmentioning

confidence: 99%

COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time

et al. 2022

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Background and objective Profiles of people with chronic obstructive pulmonary disease (COPD) often do not describe treatable traits, lack validation and/or their stability over time is unknown. We aimed to identify COPD profiles and their treatable traits based on simple and meaningful measures; to develop and validate a decision tree and to explore profile stability over time. Methods An observational, prospective study was conducted. Clinical characteristics, lung function, symptoms, impact of the disease (COPD Assessment Test—CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. A decision tree was developed and validated cross-sectionally. Stability was explored over time with the ratio between the number of timepoints that a participant was classified in the same profile and the total number of timepoints (i.e., 6). Results 352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV1 = 56.2 ± 20.6% predicted) participated and 90 (67.6 ± 8.9 years; 85.6% male; FEV1 = 52.1 ± 19.9% predicted) were followed-up. Four profiles were identified with distinct treatable traits. The decision tree included CAT (< 18 or ≥ 18 points); age (< 65 or ≥ 65 years) and FEV1 (< 48 or ≥ 48% predicted) and had an agreement of 71.7% (Cohen’s Kappa = 0.62, p < 0.001) with the actual profiles. 48.9% of participants remained in the same profile whilst 51.1% moved between two (47.8%) or three (3.3%) profiles over time. Overall stability was 86.8 ± 15%. Conclusion Four profiles and treatable traits were identified with simple and meaningful measures possibly available in low-resource settings. A decision tree with three commonly used variables in the routine assessment of people with COPD is now available for quick allocation to the identified profiles in clinical practice. Profiles and treatable traits may change over time in people with COPD hence, regular assessments to deliver goal-targeted personalised treatments are needed.

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Section: Discussionmentioning

confidence: 99%

COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time

et al. 2022

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“…In addition, even if our database had high specificity, is possible that some conditions and procedures were under-reported [ 41 ]. Furthermore, in our investigation we could not analyze the asthma–COPD overlap syndrome (ACOS) because, unfortunately, there is no specific code for ACOS in the ICD10 [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Community-Acquired Pneumonia among Patients with COPD in Spain from 2016 to 2019. Cohort Study Assessing Sex Differences in the Incidence and Outcomes Using Hospital Discharge Data

Miguel‐Díez

López-Herránz

Hernández‐Barrera

et al. 2021

JCM

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Background: To describe and analyze the incidence and hospital outcomes of patients admitted with community-acquired pneumonia (CAP) according to Chronic Obstructive Pulmonary Disease (COPD) status and sex in Spanish hospitals from 2016 to 2019. Methods: We conducted a cohort study using national hospital discharge data of all patients ≥40 years with CAP. Results: A total of 500,833 patients (59.0% men) was identified. Incidence of CAP increased over time. Age-adjusted incidence was 4.42-times higher in COPD patients. In-hospital mortality (IHM) was lower in men and women with COPD than in those without COPD (14.41% vs. 10.70% in men; 11.12% vs. 8.58%. in women; p < 0.001). The risk of dying in hospital increased with age, presence of several comorbidities (excluding T2DM that was a protective factor), and need for mechanical ventilation (non-invasive and invasive) during admission, irrespective of sex. Over time, the IHM decreased significantly in men and women with COPD. Men with COPD were significantly more likely to die in hospital than were COPD women (OR 1.13; 95%CI 1.07–1.21). Conclusions: Incidence of CAP was higher among subjects with COPD, although the effect of COPD was higher in men than in women. By contrast, IHM was lower in COPD patients, but men with COPD were significantly more likely to die in hospital than were COPD women.

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“…Following the German unification in 1990 young eastern residents disproportionately migrated to economically strong western regions, resulting in accelerated population ageing in East Germany [ 32 ]. Furthermore, even when adjusted for regional variations in populations’ age structures eastern German residents are more likely to be affected by wide spread chronic conditions including cardiovascular risk factors and diseases [ 33 – 35 ] and chronic obstructive pulmonary disease [ 36 ]. Some of the variations of disease burden between East and West Germany can be explained by differences of socioeconomic conditions between regions [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

Holstiege¹,

Akmatov²,

Kohring³

et al. 2021

BMC Public Health

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Background Research has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data. Methods We used nationwide outpatient claims data from the years 2010 to 2019 collected according to § 295 of the Code of Social Law V, covering data for all statutory health insurees (SHI) which is nearly 87% of the entire German population. We considered 15 chronic disorders based on the current state of knowledge about clinically relevant risk factors. Three risk groups for a severe COVID-19 course were defined: 1. individuals in the age group 15 to 59 years with at least two comorbid disorders; 2. individuals aged 60 to 79 years with at least one disorder and 3. all individuals 80 years and older irrespective of the presence of chronic conditions. Regional analysis was conducted at the level of administrative districts (n = 401). Results Overall, 26% of individuals over 15 years were at high risk for a severe COVID-19 course in 2019 amounting to a total number of nearly 18.5 million individuals in Germany. This included 3.8 million individuals in risk group 1, 9.2 million in risk group 2, and 5.4 million in risk group 3, corresponding to 8, 50 and 100% of German inhabitants in the respective age groups. On the level of the 17 administrative regions formed by the Association of SHI Physicians (ASHIP regions), the proportion of individuals at high risk ranged between 21% in Hamburg and 35% in Saxony-Anhalt. Small-area estimates varied between 18% in Freiburg (Baden-Württemberg) and 39% in the district Elbe-Elster (Brandenburg). Conclusions The present study provides small-area estimates of populations at high risk for a severe COVID-19 course. These data are of particular importance for planning of preventive measures such as vaccination. Trial registration not applicable.

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Comorbidity profile of patients with concurrent diagnoses of asthma and COPD in Germany

Cited by 28 publications

References 35 publications

COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time

COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time

Community-Acquired Pneumonia among Patients with COPD in Spain from 2016 to 2019. Cohort Study Assessing Sex Differences in the Incidence and Outcomes Using Hospital Discharge Data

Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

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