Abstract
Background Recent studies have shown that patients diagnosed with asthma who have other chronic comorbidities have severely worse medical outcomes. However, the number of available published studies in this field is lacking. The aim of this study was to determine the effects of comorbidities in asthmatic patients based on hospitalization and mortality rates. Methods A systematic review was conducted. Data were obtained from the electronic databases PubMed, CINAHL, and Cochrane until June 15, 2018. The primary objective of this study was to determine the effects of comorbidities on asthma hospitalization and mortality. The secondary objective was to analyze the effects of asthma comorbidity with certain chronic diseases, including COPD, obesity, obstructive sleep apnea, mental illness (anxiety and depression), diabetes mellitus, hypertension, myocardial ischemia, rhinitis, and sinusitis on asthma hospitalization and mortality. Results From potential 687 articles, only 9 were chosen based on our study inclusion criteria. Almost half of these articles were related to asthma/COPD comorbidity. There were no articles found for hypertension, myocardial ischemia, rhinitis, or sinusitis based on our inclusion/exclusion factors. Each of these 9 published articles had shown an increase in rates of hospitalization, length of stay, and/or mortality, due to asthma-related symptoms, compared to asthma-only patients. Conclusion There was determined to be a large discrepancy between the available research for various types of comorbid conditions presenting with asthma that focus on hospitalization and mortality rates. The current available literature suggests a large impact that these comorbid diseases can have on asthma-related symptoms when present together, severely affecting a patient's quality of life. We propose that further research on the effects of these comorbidities on asthma mortality and hospitalization can yield beneficial results to improve the management of asthmatic patients.
Highlights
Asthma is one of the most common pulmonary diseases among individuals of any age [1]
Most comorbidities cause some sort of change in patient outcomes, there is little research currently being conducted to analyze these varying effects with asthma, which are crucially important for the patient’s quality of life, especially due to differences being present with each varying type of disease comorbidity. e pathological process and outcomes for varying comorbidities between asthma and other severe chronic diseases is still not fully understood, and prevalent links have yet to be established, unlike other comorbid diseases, such as diabetes mellitus with renal disease [2]
Over the course of one year, there was a significant difference between the number of asthma-related emergency room (ER) visits in the obese group compared to the nonobese group (1.68 vs. 1.31 visits; P value 0.029), and the results showed how obese/overweight children had increased activity limitation and worsening asthmatic symptoms compared to nonobese children [14] (Table 2). ese findings continue to add to the apparent relationship between asthma-obesity and the frequency of ER visits and overall more difficult quality of life when compared to nonobese asthmatic patients
Summary
Asthma is one of the most common pulmonary diseases among individuals of any age (prevalence of 8% in adults and 15% in children in the United States population) [1]. Since randomized control trials are systematically lacking for certain asthma-related comorbidities, we aimed to create a review of the current available literature focusing primarily on the hospitalization and mortality rate differences in asthmatic patients with comorbidities, compared to asthma-only patients. E secondary objective was to analyze the effects of asthma comorbidity with certain chronic diseases, including COPD, obesity, obstructive sleep apnea, mental illness (anxiety and depression), diabetes mellitus, hypertension, myocardial ischemia, rhinitis, and sinusitis on asthma hospitalization and mortality. Ere were no articles found for hypertension, myocardial ischemia, rhinitis, or sinusitis based on our inclusion/exclusion factors Each of these 9 published articles had shown an increase in rates of hospitalization, length of stay, and/or mortality, due to asthma-related symptoms, compared to asthma-only patients. We propose that further research on the effects of these comorbidities on asthma mortality and hospitalization can yield beneficial results to improve the management of asthmatic patients
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