Abstract
Background: We used the Taiwan National Health Insurance Research Database (NHIRD) to determine the differences in mortality and medical burden between patients with chronic obstructive pulmonary disease (COPD) with and without stroke. Methods: We enrolled participants aged ≥20 years and defined four subgroups in this study, namely patients with COPD (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM): 491, 492, 494, and 496), patients with COPD with stroke (ICD-9 CM: 430–438), with COPD without stroke, and comparison subgroups. We calculated the hazard ratios and 95% CIs for all-cause mortality risk, average duration of hospitalization, and frequency of medical visits in these subgroups after adjustments were made for age, sex, and comorbidities. All participants were followed until the date of death, the date they were censored, the date they withdrew from the NHIRD, or 31 December, 2013. Results: In total, 9.70% (men vs. women, 11.19% vs. 8.28%) of patients with COPD developed subsequent stroke during the 14 year follow-up. After a stroke, the risk of mortality exhibited a 2.66- to 5.05-fold increase, especially in the younger ones. COPD with stroke was also a leading factor in the increase in the average number of hospitalization days and frequency of medical visits. Conclusion: The mortality risk of patients with COPD is considerably increased by stroke independent of the other effects of COPD. Moreover, the average number of hospitalization days and frequency of medical visits dramatically increased in patients with COPD after stroke.
Highlights
Chronic obstructive pulmonary disease (COPD) involves damage and inflammation of the lung airways and narrowing of the air sacs
To examine the associations between chronic obstructive pulmonary disease (COPD) and stroke, we studied the differences in all-cause mortality risk and medical burden between patients with COPD with and without stroke
This study revealed that COPD with stroke, diabetes mellitus, head injury, COPD without stroke, and male sex are leading factors contributing to the increase in average number of hospitalization days
Summary
Chronic obstructive pulmonary disease (COPD) involves damage and inflammation of the lung airways and narrowing of the air sacs. A global increase in the prevalence of COPD has been noted, with approximately 7% to 20% of the adult population reported to currently have this disease across the various countries and populations studied [1,2,3]. We used the Taiwan National Health Insurance Research Database (NHIRD) to determine the differences in mortality and medical burden between patients with chronic obstructive pulmonary disease (COPD) with and without stroke. We calculated the hazard ratios and 95% CIs for all-cause mortality risk, average duration of hospitalization, and frequency of medical visits in these subgroups after adjustments were made for age, sex, and comorbidities. COPD with stroke was a leading factor in the increase in the average number of hospitalization days and frequency of medical visits.
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