Respiratory-related death in individuals with incident asthma and COPD: a competing risk analysis

Abstract

Background Distinguishing between mortality attributed to respiratory causes and other causes among people with asthma, COPD, and asthma-COPD overlap (ACO) is important. This study used electronic health records in England to estimate excess risk of death from respiratory-related causes after accounting for other causes of death. Methods We used linked Clinical Practice Research Datalink (CPRD) primary care and Office for National Statistics mortality data to identify adults with asthma and COPD from 2005 to 2015. Causes of death were ascertained using death certificates. Hazard ratios (HR) and excess risk of death were estimated using Fine-Gray competing risk models and adjusting for age, sex, smoking status, body mass index and socioeconomic status. Results 65,021 people with asthma and 45,649 with COPD in the CPRD dataset were frequency matched 5:1 with people without the disease on age, sex and general practice. Only 14 in 100,000 people with asthma are predicted to experience a respiratory-related death up to 10 years post-diagnosis, whereas in COPD this is 98 in 100,000. Asthma is associated with an 0.01% excess incidence of respiratory related mortality whereas COPD is associated with an 0.07% excess. Among people with asthma-COPD overlap (N = 22,145) we observed an increased risk of respiratory-related death compared to those with asthma alone (HR = 1.30; 95% CI 1.21–1.40) but not COPD alone (HR = 0.89; 95% CI 0.83–0.94). Conclusions Asthma and COPD are associated with an increased risk of respiratory-related death after accounting for other causes; however, diagnosis of COPD carries a much higher probability. ACO is associated with a lower risk compared to COPD alone but higher risk compared to asthma alone.

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

“…Астма связана с увеличением смертности от респираторных заболеваний на 0,01%, тогда как ХОБЛ -на 0,07%. В этом исследовании среди пациентов с сочетанием БА и ХОБЛ (n=22 145) наблюдалcя повышенный риск респираторной смерти по сравнению с пациентами, страдающими только астмой (HR 1,30; 95% ДИ 1,21-1,40), но не ХОБЛ (HR 0,89; 95% ДИ 0,83-0,94) [994].…”

Serum YKL-40 Levels in Patients with Asthma or COPD: A Pilot Study

“…For example, it was the third global cause of death in 2019, with approximately 3.23 million deaths [ 2 ]. In contrast, respiratory mortalities associated with BA are seven-fold lower than those reported for COPD [ 3 ]. However, the global prevalence of this pulmonary disease has increased by 50% during each of the past four decades, so that it currently affects over 300 million people [ 4 ].…”

Experience of COPD and Asthma Patients in Abuja: Using Questionnaire and Spirometry

“…Globally, asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases with similar pathology [1,2] and are among the leading causes of sickness and death [2,3]. They affect patients' emotions, and physical and social function (quality of life).…”

“…The question is, is it possible to identify patients with a deteriorated quality of life based on available data in a routine hospital visit (such as medication, symptoms, Lung function, and/or comorbidity)? From previous studies more severely affected patients with changes in quality of life are largely explained by the degree of breathlessness, by the production of phlegm or cough by a small degree, and hardly at all by forced expiratory volume (FEV) [2,3,5]. Also, little is known in this area about COPD and asthma patients with a mild or moderate form of COPD and asthma that are usually treated in developing countries such as Nigeria [1,5,6].…”