Hyperlipidemia in COPD is associated with decreased incidence of pneumonia and mortality: a nationwide health insurance data-based retrospective cohort study
Authors Chan M, Lin C, Kou YR
Received 17 December 2015
Accepted for publication 14 March 2016
Published 18 May 2016 Volume 2016:11(1) Pages 1053—1059
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Ming-Chen Chan,1–3 Ching-Heng Lin,4 Yu Ru Kou1
1Institute of Physiology, National Yang-Ming University, Taipei, 2Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, 3College of Nursing, Central Taiwan University of Science and Technology, 4Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
Purpose: COPD is often associated with various comorbidities that may influence its outcomes. Pneumonia, cardiovascular disease (CVD), and cancer are the major causes of death in COPD patients. The objective of this study is to investigate the influence of comorbidities on COPD by using the Taiwan National Health Insurance database.
Patients and methods: We retrospectively analyzed the database in 2006 of one million sampling cohort. Newly diagnosed patients with COPD with a controlled cohort that was matched by age, sex, and Charlson comorbidity index (CCI) were included for analysis.
Results: In total, 1,491 patients with COPD were included for analysis (61.8% male). Patients with COPD had higher incidences of pneumonia (25.7% vs 10.4%; P<0.0001), CVD (15.1% vs 10.5%; P<0.0001), and mortality rate (26.6% vs 15.8%; P<0.001) compared with the control group in the 4-year follow-up. In patients with COPD, CCI ≥3 have a higher incidence of pneumonia (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.23–2.09; P<0.0001), CVD (HR 1.73; 95% CI 1.24–2.41; P=0.001), and mortality (HR 1.12; 95% CI 1.12–1.83; P=0.004). Among the major comorbidities of COPD, hyperlipidemia was associated with decreased incidence of pneumonia (HR 0.68; 95% CI 0.5–0.93; P=0.016) and mortality (HR 0.64; 95% CI 0.46–0.90; P=0.009), but was not associated with increased risk of CVD (HR 1.10; 95% CI 0.78–1.55; P=0.588).
Conclusion: Our results demonstrate that COPD is associated with increased incidence of pneumonia, CVD, and mortality. In patients with COPD, higher CCI is associated with increased incidence of pneumonia, CVD, and mortality. However, COPD with hyperlipidemia is associated with decreased incidence of pneumonia and mortality.
Keywords: COPD, hyperlipidemia, pneumonia, mortality
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