Influence of co-morbidities on the progression and prognosis of patients with chronic obstructive pulmonary disease in a Tunisian Hospital

Abstract

Introduction: chronic obstructive pulmonary disease (COPD) has been frequently associated with co-morbidities. The purpose of our study is to analyze the impact of co-morbidities on the progression and prognosis of COPD. Methods: we conducted a retrospective study of patients with COPD hospitalized and/or followed up in the Department of Pneumology at the Fattouma Bourguiba University Hospital in Monastir over the period January 2000-December 2017. The patients were initially divided into two groups, the G0 group (isolated COPD) and the G1 group (with at least one comorbidity). Patients in the G1 group were divided in two subgroups: A group (patients with 1-2 co-morbidities) and B group (≥ 3 comorbidities associated). Different parameters of COPD severity were compared between the different groups. Results: a total of 1152 patients with COPD were enrolled. Seventy-nine percent of patients had at least a chronic disease associated with COPD. The presence of at least one co-morbidity was associated with an increase in the number of severe exacerbations (p = 0.004), in the use of Long-term oxygen therapy (p = 0.006) and with reduced survival (p = 0.001). Similarly, a greater number of co-morbidities (≥ 3 co-morbidities) were associated with more severe systemic inflammation, more frequent use of mechanical ventilation or non-invasive ventilation (p=0.04) and reduced survival (p = 0.05). Conclusion: the presence of comorbidities in patients with COPD is associated with higher severity and poorer prognosis.