Chronic obstructive pulmonary disease (COPD) is commonly associated with multiple comorbidities. Our objective was to assess the prevalence of comorbidities in patients with COPD and to relate their prevalence to the severity of the disease by using a large German health care database. Based on the retrospective analysis of a two-year (2013-2014) database from the German Statutory Health Insurance system, we obtained a representative sample of 4,075,493 german insurants. This sample included 146,141 patients with COPD (age: >/=35 years). To these patients, we matched 1:1 by age and gender randomly selected non-COPD controls. We assessed the comorbidities and the use of cardiovascular drugs, and examined COPD subgroups according to lung function (ICD-10-coded FEV1) and the treatment with long-acting inhaled bronchodilators. Compared to non-COPD, patients with COPD had a higher prevalence of hypertension, congestive heart failure, diabetes, gastroesophageal reflux disease, chronic kidney disease, osteoporosis, psychiatric disease and lung cancer, and used more cardiovascular-related drugs. However, the prevalence of comorbidities did not correlate to the severity of airflow limitation. The results of this sizeable nationwide survey support the concept that individuals with COPD need careful evaluation regarding comorbidities. This can already be of relevance in patients with mild to moderate airflow limitation. TAKE HOME MESSAGE: Comorbidities in COPD have a complex relationship with disease severity, requiring a comprehensive therapy approach.
- Greulich, T.
- Weist, B. J. D.
- Koczulla, A. R.
- Janciauskiene, S.
- Klemmer, A.
- Lux, W.
- Alter, P.
- Vogelmeier, C. F.
Keywords
- Aged
- Bronchodilator Agents/therapeutic use
- Cardiovascular Agents/therapeutic use
- Cardiovascular Diseases/drug therapy/*epidemiology
- Comorbidity
- Diabetes Mellitus/*epidemiology
- Female
- Forced Expiratory Volume
- Gastroesophageal Reflux/*epidemiology
- Germany/epidemiology
- Heart Failure/epidemiology
- Humans
- Hypertension/epidemiology
- Lung Neoplasms/*epidemiology
- Male
- Middle Aged
- Osteoporosis/*epidemiology
- Prevalence
- Pulmonary Disease, Chronic Obstructive/drug therapy/*epidemiology/physiopathology
- Renal Insufficiency, Chronic/*epidemiology
- Retrospective Studies
- Severity of Illness Index
- Copd
- Cancer
- Cardiovascular
- Chronic obstructive pulmonary disease
- Comorbidities
- Diabetes
- Musculoskeletal
- Psychiatric disease