Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) Comorbidities in Lithuanian National Database: A Cluster Analysis.
Elena JurevičienėGreta BurneikaitėLaimis DambrauskasVytautas KasiulevičiusEdita KazėnaitėRokas NavickasRoma PuronaitėGiedre SmailytėŽydrūnė VisockienėEdvardas DanilaPublished in: International journal of environmental research and public health (2022)
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.
Keyphrases
- chronic obstructive pulmonary disease
- lung function
- end stage renal disease
- heart failure
- cross sectional
- healthcare
- newly diagnosed
- ejection fraction
- cardiovascular disease
- chronic kidney disease
- risk factors
- peritoneal dialysis
- type diabetes
- coronary artery disease
- dna methylation
- gene expression
- single cell
- prognostic factors
- adverse drug
- electronic health record
- hiv infected
- patient reported
- affordable care act