Impact of chronic obstructive pulmonary disease on patients with aortic aneurysms: A nationwide retrospective cohort study in Taiwan

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.