PURPOSE: This study aimed at establishing the frequency distribution of clinically significant comorbidities which were present in patients with established COPD diagnosis and belonged to the frequent exacerbator phenotype.We also attempted to investigate any possible relationship between body mass index and presence of comorbidities
METHODS: Among 124 COPD patients who were admitted to our department during the past 3 years 63 patients had been classified as frequent exacerbators on the basis of having 2 or more episodes of clinically important exacerbations per year.Our study group comprised of 47 male and 16 female aged 68.2±4.3yrs. (mean±SD)and had an FVC of 56,3±7.2% and an FEV1 of 35.6± 4.2% of predicted value respectively.These values were steady state values at least 30 days after their tlast exacerbation. Comorbidities in each subject were recorded on the basis of written reports of consultations requested from other specialists.We also estimated body mass index (BMI)for each patient as well as the mean exacerbation frequency per patient per year.Mean BMI was 19.2±1.2 Kgs/m2.
RESULTS: From our study group 17pts. (27%) had congestive heart failure (CF),15pts. (24%) had systemic hypertension (SH),11pts.(17%) had coronary heart disease (CD),8pts.(13%) had anemia, 7pts.(11%) had obstructive sleep apnea (OA), 6pts (10%) had diabetes mellitus (DM)and 5pts.(8%) had osteopenia (OP).The mean value of comorbitidies per patient was 2.9±1.4(mean±SD). There was a strong inverse correlation between number of comorbitidies (NC) and BMI (R=0.72, p<0.01)in the population of frequent exacerbators, described by the equation NC=-0.72×BMI+18.1 There was no significant relationship between frequency of exacerbations and NC.
CONCLUSIONS: Our results indicate a significant tendency of patients with frequent exacerbations of COPD to have several simultaneous comorbidities. Frequent exacerbators exhibit a significant inverse relationship between the number of comorbidities and their BMI.
CLINICAL IMPLICATIONS: Lower body mass index in frequent exacerbators of COPD may reflect the intensity of systemic inflammation and thus the diversity of organ systems affected along with respiratory system involvement.
DISCLOSURE: The following authors have nothing to disclose: Stylianos Michaelides, George Bablekos, Elisabeth Passalidou, Aikaterini Goritsa, George Ionas, Olga Vartzioti, Christos Kouroussis
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