COPD comorbidities independently linked to mortality

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Many COPD Comorbidities Independently Tied to Mortality
Many COPD Comorbidities Independently Tied to Mortality

HealthDay News -- Twelve comorbidities, including cancer and cardiovascular problems, are associated with a higher risk for death in patients with chronic obstructive pulmonary disease (COPD), data indicate.

"A simple disease-specific comorbidities index (COTE) helps assess mortality risk in patients with COPD," Miguel Divo, MD, from Brigham and Women's Hospital in Boston, and colleagues reported in the American Journal of Respiratory and Critical Care Medicine.

Although patients with COPD are frequently afflicted with comorbidities, few studies have examined their relationship with mortality in these patients. So Miguel Divo, MD, from Brigham and Women's Hospital in Boston, and colleagues, systematically recorded comorbidities among 1,664 patients with COPD at five health centers and performed Cox proportional hazard to determine mortality associated with each.

A total of 79 comorbidities were identified during the median 51-month follow-up period, which the researchers used to develop the COTE. They then tested the COTE to see if it added predictive information when used with the validated BODE index (body mass index; FEV1; dyspnea and exercise capacity).

Increased COTE scores significantly increased both COPD-related (hazard ratio=1.13; P< 0.001) and non COPD-related (HR=1.18; P<0.001) mortality, the researchers found, and increases in the BODE and COTE were independently associated with increased risk for death. Overall, a COTE of ≥4 points increased mortality risk 2.2-fold (HR= 2.26-2.68; P<0.001) in all BODE quartiles.

The 12 comorbidities included several types of cancer, pulmonary fibrosis, cardiovascular problems, ulcers, liver cirrhosis, diabetes with neuropathy and anxiety. 

"[These comorbidities] confer an independent risk of death and could form the core of diseases that could be screened by health care providers caring for these patients since, for some of them, there are effective interventions that may help decrease the risk of death," the researchers wrote.

Divo M et al. Am J Respir Crit Care Med. 2012; doi: 10.1164/rccm.201201-0034OC.

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