Predictive factors for COPD exacerbations and mortality in patients with overlap syndrome

Jaoude, Philippe; El-Solh, Ali

doi:10.1111/crj.13079

Cited by 17 publications

(23 citation statements)

References 48 publications

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“…The same association has been explored in longitudinal studies and it is reported that BMI is an independent prognostic factor for COPD. 7 , 25 – 28 The Copenhagen City Heart Study reported that the risk of death in COPD increases with weight loss (RR 2.14 CI 95% :(1.18–3.89)), but not with weight gain (RR 0.95; CI 95% (0.43–2.08)). 25 …”

Section: Discussionmentioning

confidence: 99%

Association between obesity and chronic obstructive pulmonary disease in Moroccan adults: Evidence from the BOLD study

et al. 2021

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Objective: The Moroccan cross-sectional study aimed to investigate obesity in association to chronic obstructive pulmonary disease in Fez city. Methods: A cross-sectional survey was carried out in Moroccan adults. Anthropometric and spirometry measurements were performed using standardized guidelines. Results: Among the 744 participants, 53.9% of were women, with a mean age of 55.27 years (SD = 10.29). Nearly all women declared themselves to be never smokers, while 21% of men were current smokers. Overall, chronic obstructive pulmonary disease prevalence decreased with body mass index ( p = 0.01) and waist circumference ( p < 0.001). The same trends were also observed in women. The adjusted regression analysis showed a significant independent association between chronic obstructive pulmonary disease and decreasing overweight (ORa: 0.66; CI95% (0.40–0.98)), obesity (ORa: 0.66 CI95%: (0.36–0.89)), and a decreasing waist circumference-abdominal obesity (ORa: 0.58 CI95%: (0.34–0.99)) in the whole population. The same association remains significant in women for overweight (ORa: 0.18 CI95%: (0.06–0.54)) and for waist circumference-abdominal obesity (ORa: 0.40 CI95%: (0.19–0.85)). All these associations disappeared for men. Conclusion: Chronic obstructive pulmonary disease decreases with the increase in body mass index and waist circumference. The effect of waist circumference on the chronic obstructive pulmonary disease was greater among women, regardless of the tobacco factor. A multicenter study would help to confirm the accuracy of these findings in a larger sample of the Moroccan population. Developed lifestyle programs in patients with chronic obstructive pulmonary disease should be considered.

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Section: Discussionmentioning

confidence: 99%

Association between obesity and chronic obstructive pulmonary disease in Moroccan adults: Evidence from the BOLD study

et al. 2021

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“…75,76 PAP therapy has been linked with physiological benefits in OS including improved arterial blood gases (reduced PaCO 2 and increased PaO 2 ), 28,32,77 6-minute walk distance, 78 forced expiratory volume in 1 second (FEV 1 ), 32,79 respiratory muscle strength, 80 skeletal muscle strength, 80 exercise capacity, 80 and mean pulmonary artery pressure. 81 Patients who are adherent to PAP therapy have been found to have reduced COPD exacerbations, 82 COPD-related hospitalizations, 46,83,84 cardiovascular events, 45 and mortality. 46,82,85,86 Most of these studies employed CPAP.…”

Section: Accepted Articlementioning

confidence: 99%

“…81 Patients who are adherent to PAP therapy have been found to have reduced COPD exacerbations, 82 COPD-related hospitalizations, 46,83,84 cardiovascular events, 45 and mortality. 46,82,85,86 Most of these studies employed CPAP. Patients with emphysema have been found to have lower CPAP adherence compared with obese patients with daytime sleepiness.…”

Section: Accepted Articlementioning

confidence: 99%

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A review of therapies for the overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease

Suri

2021

FASEB BioAdvances

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Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are common chronic diseases. These two noncommunicable diseases (NCDs) are prevalent among approximately 10% of the general population. Approximately 1% of the population is affected by the co-existence of both conditions, known as the overlap syndrome (OS). OS patients suffer from greater degrees of nocturnal oxygen desaturation and cardiovascular consequences than those with either condition in isolation.Besides OS, patients with COPD may suffer from a spectrum of sleep-related breathing disorders, including hypoventilation and central sleep apnea. The article provides an overview of the pathogenesis, associated risk factors, prevalence, and management of sleep-related breathing disorders in COPD. It examines respiratory changes during sleep caused by COPD and OSA. It elaborates upon the factors that link the two conditions together to lead to OS. It also discusses the clinical evaluation and diagnosis of these patients. Subsequently, it reviews the pathophysiological basis and the current evidence for three potential therapies: positive airway pressure therapy [including continuous positive airway pressure (CPAP) and bilevel positive airway pressure], oxygen therapy, and pharmacological therapy. It also proposes a phenotypic approach towards the diagnosis and treatment of OS and the entire spectrum of sleep-related breathing disorders in COPD. It concludes with the current evidence gaps and future areas of research in the management of OS.

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“…In fact, the presence of the OS was associated with a high frequency of hospitalizations from COPD exacerbations, severe respiratory symptoms, and low quality of life. Thus, increasing all-cause mortality compared with those with just COPD alone [46,47]. Also, the incidence of acute respiratory failure in patients diagnosed with the OS is increased compared with either disease alone and correlated to nocturnal hypoxemia particularly in obese individuals.…”

Section: Clinical and Cardiovascular Consequencesmentioning

confidence: 99%

The deleterious effects of chronic obstructive pulmonary disease and obstructive sleep apnea: pathophysiology and implications on treatment

Gharib

2020

Egypt J Bronchol

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Background: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both common in the adult population. The coexistence and association of both COPD and OSA have been described as the overlap syndrome. The scope of the present review is to address the magnitude, pathophysiology, clinical presentations, and the deleterious consequences of the coexistence of COPD and OSA in the same patient as well as the current management and treatment options of this association. Main body of abstract: Epidemiological studies showed a prevalence of the overlap syndrome of up to 1% of the adult population. However, various studies agreed that this association is due to the fact that both COPD and OSA are common rather than an interaction of pathophysiology between the two affections. Nevertheless, sleep may cause adverse effects on breathing and lung functions. While these effects can be neglected in otherwise healthy individuals, they can lead in contrast to disastrous clinical outcomes particularly in vulnerable patients with the overlap syndrome leading to increased risk of cardiovascular diseases, acute COPD exacerbations, increased rates of hospitalizations, and nocturnal deaths. Current guidelines recommend polysomnography (PSG) as the gold standard investigation to diagnose sleep disorders and overlap syndrome. Treatment may include pulmonary rehabilitation, supplemental oxygen therapy, and non-invasive ventilation. Currently, continuous positive airway pressure (CPAP) therapy is the treatment of choice for the overlap syndrome. CPAP effects include improved respiratory mechanics; sleep quality, exercise tolerance, and prolonged survival. Conclusion: Both COPD and OSA are common in the general population and present a significant risk of increased morbidity and mortality when they coexist in the same patient. Clinicians must carefully evaluate the clinical outcomes and the high risk of cardiovascular complications related to the overlap syndrome. Current data indicate that CPAP treatment leads to amelioration of the health-related quality of life and improve survival in patients with the overlap syndrome.

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Predictive factors for COPD exacerbations and mortality in patients with overlap syndrome

Cited by 17 publications

References 48 publications

Association between obesity and chronic obstructive pulmonary disease in Moroccan adults: Evidence from the BOLD study

Association between obesity and chronic obstructive pulmonary disease in Moroccan adults: Evidence from the BOLD study

A review of therapies for the overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease

The deleterious effects of chronic obstructive pulmonary disease and obstructive sleep apnea: pathophysiology and implications on treatment

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