Comorbidities in chronic obstructive pulmonary disease: Prognostic factors?

Background: Systemic inflammation may be involved in the pathogenesis of comorbidities such us cardiovascular disease, osteoporosis, and muscle wasting. Aim: To determine the impact of comorbidities on airflow limitation, exercise capacity and prognosis. Methods: Prospective study among stable COPD patients. Cardiovascular, metabolic and nutritional Com, bone abnormalities, gastro-esophageal reflux and anemia were screened in all patients. Six-minute walk test was performed measuring the walk distance. Results: Out of 70 patients, 62 were male with a mean age of 65 years. A total of 201 comorbidities were diagnosed, and 89% had at least 2 comorbidities. Among them, 48 were anteriorly diagnosed and 153 has been screened by systematically investigations performed during the study. Main comorbidities were cardiovascular disease (60%), dyslipidemia (43%) and bone demineralization (41%). Patients with comorbidities were more symptomatic (p=0.022) with comparable FEV1 and walk distance and higher exacerbation and hospitalization rates (p=0.05 and 0.022) respectively. Moreover, comorbidities number correlated positively with dyspnea severity (p=0.005), exacerbations number (p=0.013) and COPD stage (p=0.007). Whereas, neither the presence nor the number of comorbidities were correlated to the BODE index. Conclusion: These data confirm the highly prevalence of comorbidities in COPD patients and their impact on pulmonary disability and prognosis.