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Impact of chronic obstructive pulmonary disease on patients with aortic aneurysms: a nationwide retrospective cohort study in Taiwan.
BMJ Open 2017; 7(9):e015806BO

Abstract

OBJECTIVES

Aortic aneurysm (AA) is a leading cause of death worldwide. Chronic obstructive pulmonary disease (COPD) is a risk factor for AA, and the prognoses of COPD patients with AA who underwent/did not undergo an operation warrant investigation.

DESIGN

A nationwide retrospective cohort study.

SETTING

We included patients with AA older than 18 years who received their first AA diagnosis between 2005 and 2011 in Taiwan.

PARTICIPANTS

This study enrolled 3263 COPD patients with AA before propensity score matching and 2127 COPD patients with AA after propensity score matching.

OUTCOME MEASURES

The main outcomes were all-cause mortality and rehospitalisation for AA or operation. The outcomes of COPD patients with AA and COPD patients without AA during an 8-year follow-up period were examined using Cox proportional hazards models.

RESULTS

In the AA population, patients with COPD showed higher rates of mortality and rehospitalisation than patients without COPD with adjusted HRs of 1.12 (95% CI 1.03 to 1.22) and 1.11 (95% CI 1.01 to 1.23), respectively, after propensity score matching. Analysis of the patients who underwent an operation revealed that the rates of mortality of COPD and non-COPD patients were not significantly different. In contrast, among the patients who did not receive an operation, patients with COPD showed a higher mortality rate than patients without COPD with an adjusted HR of 1.11 (95% CI 1.0 to 1.22).

CONCLUSIONS

The outcomes of COPD patients with AA undergoing an operation were improved, but the mortality rate of non-COPD patients with AA remained high. An effective treatment to reduce mortality in this group warrants further investigation.

Authors+Show Affiliations

Department of Internal Medicine, Chi-Mei Medical Center, Chiali, Taiwan.Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28871015

Citation

Liao, Kuang-Ming, and Chung-Yu Chen. "Impact of Chronic Obstructive Pulmonary Disease On Patients With Aortic Aneurysms: a Nationwide Retrospective Cohort Study in Taiwan." BMJ Open, vol. 7, no. 9, 2017, pp. e015806.
Liao KM, Chen CY. Impact of chronic obstructive pulmonary disease on patients with aortic aneurysms: a nationwide retrospective cohort study in Taiwan. BMJ Open. 2017;7(9):e015806.
Liao, K. M., & Chen, C. Y. (2017). Impact of chronic obstructive pulmonary disease on patients with aortic aneurysms: a nationwide retrospective cohort study in Taiwan. BMJ Open, 7(9), pp. e015806. doi:10.1136/bmjopen-2016-015806.
Liao KM, Chen CY. Impact of Chronic Obstructive Pulmonary Disease On Patients With Aortic Aneurysms: a Nationwide Retrospective Cohort Study in Taiwan. BMJ Open. 2017 Sep 3;7(9):e015806. PubMed PMID: 28871015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of chronic obstructive pulmonary disease on patients with aortic aneurysms: a nationwide retrospective cohort study in Taiwan. AU - Liao,Kuang-Ming, AU - Chen,Chung-Yu, Y1 - 2017/09/03/ PY - 2017/9/6/entrez PY - 2017/9/6/pubmed PY - 2018/5/18/medline KW - aortic aneurysms KW - chronic obstructive pulmonary disease SP - e015806 EP - e015806 JF - BMJ open JO - BMJ Open VL - 7 IS - 9 N2 - OBJECTIVES: Aortic aneurysm (AA) is a leading cause of death worldwide. Chronic obstructive pulmonary disease (COPD) is a risk factor for AA, and the prognoses of COPD patients with AA who underwent/did not undergo an operation warrant investigation. DESIGN: A nationwide retrospective cohort study. SETTING: We included patients with AA older than 18 years who received their first AA diagnosis between 2005 and 2011 in Taiwan. PARTICIPANTS: This study enrolled 3263 COPD patients with AA before propensity score matching and 2127 COPD patients with AA after propensity score matching. OUTCOME MEASURES: The main outcomes were all-cause mortality and rehospitalisation for AA or operation. The outcomes of COPD patients with AA and COPD patients without AA during an 8-year follow-up period were examined using Cox proportional hazards models. RESULTS: In the AA population, patients with COPD showed higher rates of mortality and rehospitalisation than patients without COPD with adjusted HRs of 1.12 (95% CI 1.03 to 1.22) and 1.11 (95% CI 1.01 to 1.23), respectively, after propensity score matching. Analysis of the patients who underwent an operation revealed that the rates of mortality of COPD and non-COPD patients were not significantly different. In contrast, among the patients who did not receive an operation, patients with COPD showed a higher mortality rate than patients without COPD with an adjusted HR of 1.11 (95% CI 1.0 to 1.22). CONCLUSIONS: The outcomes of COPD patients with AA undergoing an operation were improved, but the mortality rate of non-COPD patients with AA remained high. An effective treatment to reduce mortality in this group warrants further investigation. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/28871015/Impact_of_chronic_obstructive_pulmonary_disease_on_patients_with_aortic_aneurysms:_a_nationwide_retrospective_cohort_study_in_Taiwan_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=28871015 DB - PRIME DP - Unbound Medicine ER -