scholarly journals Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China: a cross-sectional study

2021 ◽  
Author(s):  
Pan Zhang ◽  
Bi Chen ◽  
Heqing Lou ◽  
Yanan Zhu ◽  
Peipei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Overlap Syndrome ◽  
Neck Circumference ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Independent Risk Factors

Abstract ‘Overlap syndrome’ refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. We conducted a cross-sectional study in 842 patients with COPD. We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Participants were divided into a COPDOSA group with AHI ≥ 15 events per hour and a COPD group with AHI < 15 events per hour. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1%, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPDOSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD (FEV1% <50%) had a lower risk of OSA compared with patients with mild or moderate COPD (β=−0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusions Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

scholarly journals Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Pan Zhang ◽  
Bi Chen ◽  
Heqing Lou ◽  
Yanan Zhu ◽  
Peipei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Overlap Syndrome ◽  
Neck Circumference ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Independent Risk Factors ◽  
Severe Copd

Abstract Background “Overlap syndrome” refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. Methods We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. Results A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1% pred, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPD-OSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD had a lower risk of OSA compared with patients with mild or moderate COPD (β =  − 0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusion Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

scholarly journals Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Manyun Tang ◽  
Yidan Wang ◽  
Mengjie Wang ◽  
Rui Tong ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p &lt; 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

scholarly journals Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Manyun Tang ◽  
Yunxiang Long ◽  
Shihong Liu ◽  
Xin Yue ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Partial Pressure ◽  
Cardiovascular Events ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Prevalence Rates ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated.Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients.Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events.Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P &lt; 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P &lt; 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P &gt; 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels.Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.

scholarly journals Study of red cell distribution width levels and its correlation with severity of disease in patient with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
Shashidhar Ramappa ◽  
Aishhwarrya Umeshchandra G. ◽  
Sheshan V. ◽  
Manigandan .
Keyword(s):  
Cross Sectional Study ◽  
Red Cell Distribution Width ◽  
Chronic Obstructive ◽  
Red Cell ◽  
Cell Distribution ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Severity Of Disease ◽  
Copd Patients

Background:COPD has been accepted as component of systemic inflammatory syndrome. Red cell distribution width (RDW) is a measure of coefficient of variation of mean corpuscular volume which increases in chronic systemic inflammation. The aim of the study was to evaluate the RDW as a predictor of severity of COPD using BODE index.Methods:In this cross-sectional study 107 COPD patients were evaluated by measuring RDW and this was correlated with the severity of disease using GOLD staging.Results:RDW correlates well with COPD patients. Significant correlation of RDW with BODE index (r=0.650, p and It; 0.001), gold staging (r=0.459, p and It; 0.001), 6MWT (r=0.697, p and It; 0.001) were observed.Conclusions: RDW was found to increase in patients with increasing severity of COPD. Hence its potential role as a marker of severity of disease and in predicting risk of cardiovascular disease can be explored.

scholarly journals The Prevalence of Diabetes Mellitus in Chronic Obstructive Pulmonary Disease Patients

2020 ◽  
Vol 40 (1) ◽  
pp. 48-57
Author(s):  
Mariska Pangaribuan ◽  
Faisal Yunus ◽  
Triya Damayanti ◽  
Rochsismandoko Rochsismandoko
Keyword(s):  
Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Inhaled Corticosteroid ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients

Backgrounds: Type 2 diabetes mellitus (DM) is a common comorbidity of COPD. COPD may be considered as a risk factor for new onset type 2 DM via multiple pathophysiological alterations such as systemic inflammation, smoking, oxidative stress, obesity and inhaled corticosteroid use. Exact prevalence of DM in COPD patients in Indonesia still unclear. Co-morbid conditions like DM have great impact on the outcome of COPD in the form of severity, morbidity and mortality. Methods: A cross sectional study was done in Asthma-COPD clinic Persahabatan Hospital from February to March 2017 to screen COPD patients for DM. Sixty-four subjects were recruited. Interview, physical examination and laboratory testing were performed in all subjects. Results: A total of 64 patients with COPD (Males=60, Female=4) with mean age 65±8.7 were screened for DM. Patients with known history of DM were 12 subjects (18.8%) and were enrolled as known DM cases. Remaining 52 subjects (81.3%) whose DM status was unclear were screened by random or fasting blood sugar and HbA1c. Two subjects (3.1%) were considered as newly diagnosed DM cases. Prevalence of DM in present study was 21.9%. Number of patients with pre-diabetes was 16 subjects (25%). There was no significant relationship between gender, age, smoking, nutritional status, airflow limitation and inhaled corticosteroid use in occurrence of DM among COPD patients. Conclusions: Prevalence of DM in COPD patients in the present study is 21.9%. It is important to screen all COPD patients for DM routinely. (J Respir Indo. 2020; 40(1): 48-57)

scholarly journals Prevalence of Overlap Syndrome. Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease. A study protocol.

2016 ◽  
Vol 14 ◽  
pp. 437
Author(s):  
Julio Cesar Mendes De Oliveira ◽  
Anderson Soares Silva ◽  
Ana Carolina Negrinho de Oliveira Beloto ◽  
Jéssica Julioti Urbano ◽  
Ezequiel Fernandes De Oliveira ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulmonary Disease ◽  
Overlap Syndrome ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Introduction: Chronic obstructive pulmonary disease (COPD) and Obstructive sleep apnea (OSA) cause an inflammatory response and hypoxia. Patients who have both conditions have increased morbidity and mortality. Overlap syndrome between OSA and COPD is important but under-recognised. Objectives: We aimed to determine the prevalence and severity of overlap syndrome in patients with COPD through the overnight standard polysomnography. Methods/Design: A consecutive single-center cross-sectional study will be performed. The design, conduct and report of this study followed the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The sample will be of convenience, recruited consecutively with respiratory complaints that seek care in a private clinic specializing in pulmonology in the city of Cascavel, in the state of Paraná, from September 2016 to July 2017. All subjects will be submitted to the same evaluation protocol described subsequently. Initially will be collected data on baseline demographic, anthropometric and clinical aspects, including body mass index, neck, hip and waist circumferences, respiratory and cardiac rates, peripheral blood pressure, and BODE index. After this phase of the study, patients will perform lung function tests through petismography, sleep studies using the standard overnight PSG, and respond to the Berlin and Pittsburgh questionnaires, and Epworth Sleepiness Scale. 

scholarly journals CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

2016 ◽  
Vol 23 (09) ◽  
pp. 1073-1078
Author(s):  
Atif Sitwat Hayat ◽  
Abdul Haque Khan ◽  
Ghulam Nabi Pathan ◽  
Mohammad Zubair Mushtaque
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Copd Patients ◽  
Study Results

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).

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