ABSTRACT
INTRODUCCIÓN: La enfermedad cardiovascular tiene un impacto negativo en el pronóstico vital de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC), siendo la dislipidemia (DLP) y la hipertensión arterial (HTA) los factores de riesgo más prevalentes. El objetivo del estudio fue: 1) evaluar la relación existente entre el diagnóstico de DLP y la presencia de enfermedad cardiovascular en pacientes con EPOC, y compararlo con otros factores conocidos de riesgo cardiovascular; y 2) determinar la relación entre las diferentes comorbilidades cardiovasculares y los grupos de gravedad según la clasificación GOLD 2017. MÉTODOS: Estudio observacional transversal de 454 pacientes con EPOC en seguimiento ambulatorio. Se calculó la prevalencia de cada una de las comorbilidades cardiovasculares y el riesgo de que cada uno de los factores de riesgo cardiovascular se presentase conjuntamente con una enfermedad vascular (RRij). RESULTADOS: El 66,7% de los pacientes eran dislipidémicos. La DLP mostró una mayor relación con la presencia de accidentes cerebrovasculares (ACV) (RRij 1.36; p = 0,0054), enfermedad renal crónica (ERC) (RRij 1.34; p = 0,00023) y arteriopatía periférica (AP) (RRij 1.38; p = 0,00015); la HTA se relacionó mayormente con ACV (RRij 1,41; p = 0,0014) y ERC (RRij 1,42; p < 0,0001); la DMT2 con AP (RRij 1,90; p = 0,0001), insuficiencia cardiaca (IC) (RRij 1,74; p = 0,0002) y ERC (RRij 1,76; p < 0,0001); la obesidad con IC (RRij 1,60; p = 0,0009) y ERC (RRij 1.54; p = 0,0001). CONCLUSIÓN: La DLP se relacionó con la presencia de ACV, ERC y AP. La HTA y DMT2 se relacionaban mayoritariamente con IC y ACV
INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pulmonary Disease, Chronic Obstructive/complications , Dyslipidemias/complications , Cardiovascular Diseases/complications , Risk Factors , Cross-Sectional Studies , Comorbidity , SpainABSTRACT
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Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/complications , Coronavirus Infections/complications , Disease Progression , Severe Acute Respiratory Syndrome/complications , Risk Factors , Symptom Flare Up , Severe acute respiratory syndrome-related coronavirus/pathogenicity , Survivors/statistics & numerical dataABSTRACT
Introducción: El score COPD-LUCSS-DLCO ha sido validado como una herramienta predictiva capaz de identificar pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y alto riesgo de fallecer por cáncer de pulmón (CP). No obstante, hasta la fecha no se han realizado estudios acerca de su uso en la práctica clínica habitual. El objetivo del estudio fue estimar las puntuaciones del score COPD-LUCSS-DLCO en pacientes con EPOC atendidos en consultas de Neumología, así como determinar la incidencia de CP en cada uno de los subgrupos. Material y métodos: Estudio observacional retrospectivo de una cohorte de 159 pacientes con EPOC en seguimiento en consultas ambulatorias de Neumología. Se calculó la puntuación del score COPD-LUCSS-DLCO (puntuación de 0-8) a cada uno de los sujetos, considerando bajo riesgo (BR) entre 0-3 puntos y alto riesgo (AR) ≥ 3,5 puntos. Se estimó la incidencia del CP en cada uno de los subgrupos. Resultados: El 62% presentaban un score de AR. Se estimó una tasa global de CP de 30 por 1.000 pacientes con EPOC-año (IC 95%:16-53), de 44 por 1.000 pacientes con EPOC-año (IC 95%: 18-76) entre los catalogados de AR y de 17 por 1.000 pacientes con EPOC-año (IC 95%: 4-50). Conclusiones: El uso del score COPD-LUCSS-DLCO en la práctica clínica habitual podría permitir detectar pacientes con un mayor riesgo de desarrollar CP, lo cual ayudaría a una mejor gestión de casos en un programa de screening de CP
Introduction: The COPD-LUCSS-DLCO score had been validated as a predictive tool capable of identifying patients with chronic obstructive pulmonary disease (COPD) and a high mortality risk associated with lung cancer (LC); however, studies have not been conducted yet on its use in standard clinical practice. The aim of this study was to estimate the COPD-LUCSS-DLCO scores for patients with COPD treated in Pulmonology consultations and to determine the incidence of LC in each of the subgroups. Material and methods: A retrospective observational study was conducted with a cohort of 159 patients with COPD in Pulmonology outpatient follow-up consultations. We calculated the COPD-LUCSS-DLCO score (0-8) for each patient, with low risk considered at 0-3 points and high risk at ≥3.5 points. We calculated the incidence rate of LC in each of the subgroups. Results: Sixty-two percent of the patients had a high-risk score. We estimated an overall LC rate of 30 per 1000 patients with COPD-year (95% CI: 16-53), 44 per 1000 patients with COPD-year (95% CI: 18-76) among those categorised as high risk and 17 per 1000 patients with COPD-year among those categorised as low risk (95% CI: 4-50). Conclusions: The use of the COPD-LUCSS-DLCO score in standard clinical practice could help detect patients with a greater risk of developing LC, which could help to better manage cases in an LC screening programme
Subject(s)
Humans , Male , Female , Pulmonary Disease, Chronic Obstructive/complications , Early Detection of Cancer/methods , Lung Neoplasms/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Risk Adjustment/methods , Risk Factors , Retrospective Studies , Tobacco Use Disorder/complications , Body Mass IndexABSTRACT
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Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Spirometry/methods , Bronchodilator Agents/therapeutic use , Respiratory Function Tests/statistics & numerical data , Disease ProgressionABSTRACT
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Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Quality of Health Care/trends , Quality Improvement/trends , Respiratory Function Tests , Pulmonary Disease, Chronic Obstructive/historyABSTRACT
Introducción. La relación entre la enfermedad pulmonar obstructiva crónica (EPOC) y la incidencia global de cáncer es poco conocida. El objetivo del estudio fue analizar la incidencia de cáncer (tanto de localización pulmonar como extrapulmonar) en pacientes con EPOC en seguimiento en una consulta ambulatoria especializada, así como valorar su relación con el grado de obstrucción al flujo aéreo. Metodología. Estudio observacional prospectivo de una cohorte de 308 pacientes con EPOC en seguimiento en consultas ambulatorias de neumología durante el periodo comprendido entre enero de 2012 y diciembre de 2015. Las neoplasias diagnosticadas en este periodo se dividieron en pulmonares y extrapulmonares. Resultados. Las tasas de incidencia global de cáncer, de cáncer de pulmón (CP) y de cáncer extrapulmonar fueron de 10,3, 3,4 y 7,3 casos por 1.000 pacientes EPOC-año, respectivamente. Los tumores más frecuentes fueron el CP (31%), los del tracto genitourinario (29%) y digestivo (21%). Los estadios leve-moderado (gradosI-II de la GOLD 2009) y el incremento del índice paquetes-año (IPA) se relacionaron con un aumento en la aparición de neoplasias con un odds ratio (OR) de 2,16 (intervalo de confianza al 95% [IC95%]: 1,087-4,309; p=0,026) y 1,01 (IC95%:1,002-1,031; p=0,023), respectivamente. Conclusión. La incidencia de cáncer de localización extrapulmonar en pacientes con EPOC duplica a la de CP. Los estadiosI-II de la GOLD 2009 y el IPA se relacionan de forma significativa con la aparición de neoplasias (AU)
Introduction. The relationship between chronic obstructive pulmonary disease (COPD) and the overall incidence of cancer is poorly understood. The aim of this study was to analyse the incidence of cancer (pulmonary or extrapulmonary) in patients with COPD during follow-up in a specialised outpatient unit, as well as to assess its relationship with the degree of airflow obstruction. Methodology. A prospective observational study was conducted with a cohort of 308 patients with COPD in pulmonology outpatient follow-up consultations from January 2012 to December 2015. The diagnosed malignancies during this period were divided into pulmonary and extrapulmonary. Results. The overall incidence rate of cancer, lung cancer and extrapulmonary cancer were 10.3, 3.4 and 7.3 cases per 1,000 patients with COPD per year, respectively. The most common cancers were lung cancer (31%), genitourinary tract cancer (29%) and gastrointestinal cancer (21%). Mild-moderate stages (gradeI-II of the 2009 GOLD classification) and the increase in the pack-year index (PYI) were related to an increase in the onset of malignancies, with an odds ratio (OR) of 2.16 (95% confidence interval [95% CI]: 1.087-4.309; P=.026) and 1.01 (95% CI: 1.002-1.031; P=.023), respectively. Conclusion. The incidence of extrapulmonary cancer in patients with COPD was twice that of lung cancer; stagesI-II of the 2009 GOLD classification and the PYI were significantly related to the onset of malignancies (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pulmonary Disease, Chronic Obstructive/complications , Neoplasms/epidemiology , Ambulatory Care/statistics & numerical data , Risk Factors , Smoking/epidemiology , Odds Ratio , Confidence Intervals , Prospective Studies , 28599ABSTRACT
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Humans , Pulmonary Medicine/methods , Primary Health Care , Health Services , Hospital Units/organization & administration , Hospital Units/standardsABSTRACT
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Humans , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life , Prognosis , Dyspnea/complications , ComorbidityABSTRACT
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Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapy , Fever/complications , Air Pollutants, Occupational/adverse effects , Antipyretics/therapeutic use , Anti-Bacterial Agents/therapeutic use , Organometallic Compounds/adverse effects , Occupational Exposure/adverse effects , Diagnosis, Differential , Smoke/adverse effectsABSTRACT
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