Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) Comorbidities in Lithuanian National Database: A Cluster Analysis.

Elena Jurevičienė,Vytautas Kasiulevičius,Edita Kazėnaitė,Roma Puronaitė,Rokas Navickas,Greta Burneikaitė,Giedrė Smailytė,Edvardas Danila,Laimis Dambrauskas,Žydrūnė Visockienė

doi:10.3390/ijerph19020970

Abstract

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.

Highlights

Introduction published maps and institutional affilHealth care systems face the challenge of the aging population and an increasing number of chronic non-communicable diseases per patient
A total of 1.5% of them had chronic obstructive pulmonary disease (COPD), with prevalence increasing with age and male gender (69.1% vs. 34.7%), more COPD patients lived in rural areas (35.4% vs. 27.0%). (Table 1)
A significantly higher prevalence was found in COPD patients for cardiovascular diseases (CVD), lung cancer, and kidney diseases (Table 2)

Summary

Introduction

Introduction published maps and institutional affilHealth care systems face the challenge of the aging population and an increasing number of chronic non-communicable diseases per patient. The increased prevalence of multimorbidity worldwide leads to the high utilization of limited health care resources, lower quality of life, and higher mortality [1,2,3,4,5,6,7]. Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases in the world today, causing high morbidity and mortality in the adult population [8,9]. Both death rates and the prevalence of COPD steeply increase with age.

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Conclusion