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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 38124

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Prof. Dr. Rodrigo Jiménez-García

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Guest Editor

Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: chronic obstructive pulmonary disease

Special Issue Information

Dear Colleagues,

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable condition that is characterized by persistent and often progressive airflow limitation, mainly associated with smoking tobacco. It is a leading cause of morbidity and mortality worldwide and induces a substantial economic and social burden. In addition, the prevalence and burden of COPD are projected to increase over the coming decades, due to continue exposure to COPD risk factors and aging of the world population.

Symptoms including dyspnea, cough, and sputum production are common in COPD patients and constitute risk factors for poor health-related quality of life and a decrease in their physical activity. Other conditions that are common in COPD patients include pain, disabilities, respiratory infections, and other concomitant physical and mental chronic comorbidities. Previous investigations have found that COPD patients use health care services, including hospitalizations, primary care, specialist care and ER more frequently than age and sex-matched non-COPD persons. Finally, most patients with COPD require pharmacological treatments and in many cases respiratory support with oxygen or non-invasive ventilation devices.

For all these reasons, COPD constitutes a very relevant public health and clinical problem and is necessary to continue investigating all issues related to how COPD affects the life of people that suffer this condition.

Dr. Rodrigo Jiménez-García
Guest Editor

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Keywords

Health-related quality of life
Mental health
Health services utilization
Disability
Pain
Life styles
Oxygen therapy
Respiratory support
Pharmacological treatment
Comorbidities

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Published Papers (10 papers)

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Research

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13 pages, 577 KiB

Open AccessArticle

Frequency and Associated Factors of Suicidal Ideation in Patients with Chronic Obstructive Pulmonary Disease

by Carlos Roncero, Joselín Pérez, Jesús Molina, José Antonio Quintano, Ana Isabel Campuzano, Javier Pérez and Marc Miravitlles

J. Clin. Med. 2022, 11(9), 2558; https://doi.org/10.3390/jcm11092558 - 2 May 2022

Cited by 4 | Viewed by 3921

Abstract

We aimed to examine the prevalence of suicidal ideation in patients with chronic obstructive pulmonary disease (COPD) and the association between demographic and clinical variables and the occurrence of suicidal thoughts. This was a cross-sectional study. Sociodemographic and clinical data were recorded, and questionnaires were used to assess depressive symptoms (Beck Depression Inventory), comorbidities (Charlson Index), cognitive performance (Mini Mental State Examination), and quality of life (EuroQoL-5 dimensions and CAT). Specific questions about suicide-related behavior were included. Multivariate logistic regression analysis identified the significant factors associated with previous suicidal ideation and suicide attempts. The analysis included 1190 subjects. The prevalence of suicidal ideation and suicide attempts were 12.1% and 2.5%, respectively. Severely depressed patients had the highest prevalence of suicide-related behavior. The adjusted logistic model identified factors significantly associated with suicidal ideation: sex (odds ratio (OR) for women vs. men = 2.722 (95% confidence interval (CI) = 1.771–4.183)), depression score (OR = 1.163 (95% IC = 1.127–1.200)), and Charlson Index (OR 1.228 (95% IC 1.082–1.394)). Suicidal ideation is common in COPD patients, especially in women. While addressing suicidal ideation and suicide prevention, clinicians should first consider the management of depressive symptomatology and the improvement of coping strategies. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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10 pages, 942 KiB

Open AccessArticle

The Impact of the Age, Dyspnoea, and Airflow Obstruction (ADO) Index on the Medical Burden of Chronic Obstructive Pulmonary Disease (COPD)

by Chin-Ling Li, Mei-Hsin Lin, Yuh-Chyn Tsai, Ching-Wan Tseng, Chia-Ling Chang, Lien-Shi Shen, Ho-Chang Kuo and Shih-Feng Liu

J. Clin. Med. 2022, 11(7), 1893; https://doi.org/10.3390/jcm11071893 - 29 Mar 2022

Cited by 5 | Viewed by 2593

Abstract

There are currently no good indicators that can be used to predict the medical expenses of chronic obstructive pulmonary disease (COPD). This was a retrospective study that focused on the correlation between the age, dyspnoea, and airflow obstruction (ADO) index and the Charlson comorbidity index (CCI) on the medical burden in COPD patients, specifically, those of patients with complete ADO index and CCI data in our hospital from January 2015 to December 2016. Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilisation was positively correlated with the ADO index. A significant association was found between the ADO index and CCI of COPD patients (p < 0.001). In-hospitalization expenses were positively correlated with the CCI (p < 0.001). Under the same CCI, the higher the ADO score, the higher the hospitalisation expenses. The ADO quartiles were positively correlated with the number of hospitalisations (p < 0.001), hospitalisation days (p < 0.001), hospitalisation expenses (p = 0.03), and total medical expenses (p = 0.037). Findings from this study show that the ADO index can predict the medical burden of COPD. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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14 pages, 276 KiB

Open AccessArticle

Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016–2019)

by Javier de-Miguel-Diez, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Jose M. de-Miguel-Yanes, David Carabantes-Alarcon and Ana Lopez-de-Andres

J. Clin. Med. 2021, 10(22), 5453; https://doi.org/10.3390/jcm10225453 - 22 Nov 2021

Cited by 6 | Viewed by 2224

Abstract

Background: We aim to analyze incidence and outcomes of patients hospitalized with hospital-acquired pneumonia (HAP) according to chronic obstructive pulmonary disease (COPD) status and sex in Spain (2016–2019). Methods: We conducted a retrospective cohort study using national hospital discharge data of patients ≥40 years with a primary diagnosis of HAP, using the specific diagnostics of non-ventilator (NV)-HAP and ventilator-associated pneumonia (VAP). Results: We identified 37,029 patients with HAP ((NV)-HAP 87.28%, VAP 12.72%), 13.40% with COPD. HAP incidence increased over time, but only in subjects without COPD (p < 0.001). In women, incidence of HAP and (NV)-HAP was similar regardless of COPD status, but VAP incidence was lower in COPD women (p = 0.007). In men, the incidence of (NV)-HAP was significantly higher in those with COPD, while VAP incidence was lower in COPD men (p < 0.001). The in-hospital mortality (IHM) was similar in men and women with and without COPD. The risk of dying in hospital increased with age, congestive heart failure, cancer, and dialysis among men and women with COPD. Men that underwent surgery had a lower risk of IHM. VAP increased 2.58-times the probability of dying in men and women. Finally, sex was not associated with IHM among COPD patients. Conclusions: Incidence of HAP was significantly higher in COPD patients than in those without COPD, at the expense of (NV)-HAP but not of VAP. When stratifying by sex, we found that the difference was caused by men. IHM was similar in COPD and non-COPD patients, with no significant change overtime. In addition, sex was not associated with IHM. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

13 pages, 304 KiB

Open AccessArticle

Does Health Literacy Reinforce Disease Knowledge Gain? A Prospective Observational Study of Hungarian COPD Patients

by Orsolya Papp-Zipernovszky, Márta Csabai, Peter J. Schulz and János T. Varga

J. Clin. Med. 2021, 10(17), 3990; https://doi.org/10.3390/jcm10173990 - 3 Sep 2021

Cited by 8 | Viewed by 2691

Abstract

We set out to measure the health literacy (HL) of COPD patients using the Short Test of Functional Health Literacy (S-TOFHLA), perception-based screening questions (BHLS), and a specific disease knowledge test (COPD-Q). Our main focus is the relationship between functional HL and patients’ disease-knowledge, which contributes to the clarification of the relationship between the different kinds of HL. In two prospective observational studies, 151 COPD patients (80 males, mean age: 62 ± 9 years) completed a questionnaire containing HL measurements, psychological tests (e.g., the Self-Control and Self-Management Scale), and questions regarding subjective health status. Medical data of the patients from the MedSole system were added. The HL scores of the COPD patients were compared to a representative sample using a t-test. Furthermore, correlations of HL with demographic, psychological, and medical variables were calculated within the patient group. The relations among the different HL measurements were tested by chi-square trials. COPD patients had significantly lower HL, as measured by S-TOFHLA. Younger and higher educated patients possessed higher S-TOFHLA scores. Unlike the demographic variables, general self-management showed significant correlations with both BHLS and with COPD-Q. Out of the medical variables, objective health status was associated with BHLS and COPD-Q. Neither BHLS nor S-TOFHLA had a correlation with COPD-Q, but they correlated with each other. We found S-TOFHLA to be a better tool in the medical context. There is a clear gap between self-perceived/functional HL and the necessary disease knowledge. Rehabilitation care for patients with lower HL was more advantageous. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

10 pages, 268 KiB

Open AccessArticle

Effect of COPD on the Hospital Outcomes and Mortality among Hemorrhagic Stroke Patients. Sex Differences in a Population-Based Study

by Javier de Miguel-Diez, Marta Lopez-Herranz, Rodrigo Jiménez-García, Valentín Hernández-Barrera, Isabel Jimenez-Trujillo, Jose M. de Miguel-Yanes and Ana Lopez de Andres

J. Clin. Med. 2021, 10(11), 2491; https://doi.org/10.3390/jcm10112491 - 4 Jun 2021

Cited by 6 | Viewed by 2317

Abstract

(1) Background: It is not well known whether there is an association between COPD and hemorrhagic stroke (HS). We aim to analyze the incidence, clinical characteristics, procedures, and outcomes of HS in patients with and without COPD and to assess sex differences. Secondly, to identify factors associated with in-hospital mortality (IHM). (2) Methods: Patients aged ≥40 years hospitalized with HS included in the Spanish National Hospital Discharge Database (2016–2018) were analyzed. Propensity score matching (PSM) was used to compare patients according to sex and COPD status. (3) Results: We included 55,615 patients (44.29% women). Among men with COPD the HS adjusted incidence was higher (IRR 1.31; 95% CI 1.24–1.57) than among non-COPD men. COPD men had higher adjusted incidence of HS than COPD women (IRR 1.87; 95% CI 1.85–1.89). After matching, COPD men had a higher IHM (29.96% vs. 27.46%; p = 0.032) than non-COPD men. Decompressive craniectomy was more frequently conducted among COPD men than COPD women (6.74% vs. 4.54%; p = 0.014). IHM increased with age and atrial fibrillation, while decompressive craniectomy reduced IHM. (4) Conclusions: COPD men had higher incidence and IHM of HS than men without COPD. COPD men had higher incidence of HS than COPD women. Decompressive craniectomy was more frequently conducted in COPD men than COPD women and this procedure was associated to better survival. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

20 pages, 2641 KiB

Open AccessArticle

Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006–2017: Evidence from Spanish National Health Surveys

by Silvia Portero de la Cruz and Jesús Cebrino

J. Clin. Med. 2021, 10(11), 2291; https://doi.org/10.3390/jcm10112291 - 25 May 2021

Cited by 4 | Viewed by 2998

Abstract

Certain conditions such as common mental disorders (CMDs), functional limitation (FL) and poor diet quality may affect the lives of individuals who suffer from chronic obstructive pulmonary disease (COPD). This study sought to examine time trends in the prevalence of CMDs, FL and diet quality among male and female COPD patients living in Spain from 2006 to 2017 and to identify which factors were related to CMDs, FL and a poor/improvable diet quality in these patients. We performed a cross-sectional study among COPD patients aged ≥ 40 years old using data from the Spanish National Health Surveys conducted in 2006, 2011 and 2017, identifying a total of 2572 COPD patients. Binary logistic regressions were performed to determine the characteristics related to CMDs, FL and poor/improvable diet quality. Over the years of the study, the prevalence of FL among female COPD patients increased (p for trend <0.001). In addition, CMDs were associated to body mass index (BMI), educational level, physical activity, smoking status, occupation, chronic conditions and alcohol consumption; FL was related to age, living with a partner, educational level, physical activity and chronic conditions; and poor/improvable diet quality was associated to age, smoking status, BMI and physical activity. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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8 pages, 502 KiB

Open AccessArticle

Predictors of Single Bronchodilation Treatment Response for COPD: An Observational Study with the Trace Database Cohort

by Laura Carrasco Hernández, Candela Caballero Eraso, Borja Ruiz-Duque, María Abad Arranz, Eduardo Márquez Martín, Carmen Calero Acuña and Jose Luis Lopez-Campos

J. Clin. Med. 2021, 10(8), 1708; https://doi.org/10.3390/jcm10081708 - 15 Apr 2021

Cited by 1 | Viewed by 2019

Abstract

Chronic obstructive pulmonary disease (COPD) patients constitute a heterogeneous population in terms of treatment response. Our objective was to identify possible predictive factors of response to treatment with single bronchodilation monotherapy in patients diagnosed with COPD. The Time-based Register and Analysis of COPD Endpoints (TRACE; clinicaltrials.gov NCT03485690) is a prospective cohort of COPD patients who have been attending annual visits since 2012. Patients who were kept on a single bronchodilator during the first year of follow-up were selected. The responders were defined according to all of the following variables: any improvement in morning post-dose forced expiratory volume in 1 s or deterioration <100 mL, no change or improvement in dyspnea score, and no occurrence of exacerbations. Significant and plausible variables were analyzed using a proportional hazard Cox regression for single bronchodilator responders. We analyzed 764 cases, of whom 128 (16.8%) were receiving monotherapy with one bronchodilator. Of these, 85 patients (66.4%) were responders. Factors affecting responder status were: female gender (hazard ratio (HR) 0.276; 95% confidence interval (CI) 0.089–0.858), dyslipidemia (HR 0.436; 95%CI 0.202–0.939), not performing regular exercise (HR 0.523; 95%CI 0.254–1.076), active smoking (HR 0.413; 95%CI 0.186–0.920), and treatment adherence (HR 2.527; 95%CI 1.271–5.027). The factors associated with a single bronchodilation response are mainly non-pharmacological interventions and comorbidities. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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12 pages, 563 KiB

Open AccessArticle

The Impact of COPD in Trends of Urinary Tract Infection Hospitalizations in Spain, 2001–2018: A Population-Based Study Using Administrative Data

by Javier de Miguel-Diez, Romana Albaladejo-Vicente, Domingo Palacios-Ceña, David Carabantes-Alarcon, José Javier Zamorano-Leon, Marta Lopez-Herranz and Ana Lopez-de-Andres

J. Clin. Med. 2020, 9(12), 3979; https://doi.org/10.3390/jcm9123979 - 9 Dec 2020

Cited by 4 | Viewed by 2294

Abstract

(1) Background: To examine trends in incidence and outcomes of urinary tract infections (UTIs) among men and women with or without chronic obstructive pulmonary disease (COPD), and to identify the predictors for in-hospital mortality (IHM). (2) Methods: We included patients (aged ≥40 years) who were hospitalized with UTIs between 2001 and 2018. Data were collected from the Spanish National Hospital Discharge Database. (3) Results: We identified 748,458 UTI hospitalizations, 6.53% with COPD. The UTIs incidence increased over time. It was 1.55 times higher among men COPD patients than among non-COPD men (incidence rate ratio (IRR) 1.55; 95% CI 1.53–1.56). The opposite happened in women with COPD compared to non-COPD women (IRR 0.30; 95% CI 0.28–0.32). IHM was higher in men with COPD than non-COPD men (5.58% vs. 4.47%; p < 0.001) and the same happened in women (5.62% vs. 4.92%; p < 0.001). The risk of dying increased with age and comorbidity, but the urinary catheter was a protective factor among men (OR 0.75; 95% CI 0.64–0.89). Multivariable analysis showed a significant reduction in the IHM over time for men and women with COPD. Suffering from COPD only increased the risk of IHM among men (OR 1.07; 95% CI 1.01–1.13). (4) Conclusions: The incidence of UTIs increased over time. Suffering COPD increased the risk of IHM among men, but not among women. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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Review

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9 pages, 2451 KiB

Open AccessReview

Matching the Inhaler to the Patient in COPD

by Rudi Peché, Darush Attar-Zadeh, Jane Scullion and Janwillem Kocks

J. Clin. Med. 2021, 10(23), 5683; https://doi.org/10.3390/jcm10235683 - 1 Dec 2021

Cited by 12 | Viewed by 4369

Abstract

Selecting the most appropriate inhalation device from the wide range available is essential for the successful management of patients with chronic obstructive pulmonary disease. Although choice is good for healthcare professionals, knowing which inhaler to prescribe is a complex consideration. Among the key factors to consider are quality of disease control, inhaler technique, inhaler resistance and inspiratory flow, inhaler design and mechanisms of drug delivery, insurance and reimbursement restrictions, and environmental impact. In this article, we offer a simple, practical tool that brings together all these factors and includes hyperlinks to other published resources from the United Kingdom, Belgium, and The Netherlands. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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20 pages, 795 KiB

Open AccessReview

Chronic Obstructive Pulmonary Disease: Epidemiology, Biomarkers, and Paving the Way to Lung Cancer

by Klára Szalontai, Nikolett Gémes, József Furák, Tünde Varga, Patrícia Neuperger, József Á. Balog, László G. Puskás and Gábor J. Szebeni

J. Clin. Med. 2021, 10(13), 2889; https://doi.org/10.3390/jcm10132889 - 29 Jun 2021

Cited by 76 | Viewed by 11190

Abstract

Chronic obstructive pulmonary disease (COPD), the frequently fatal pathology of the respiratory tract, accounts for half a billion cases globally. COPD manifests via chronic inflammatory response to irritants, frequently to tobacco smoke. The progression of COPD from early onset to advanced disease leads to the loss of the alveolar wall, pulmonary hypertension, and fibrosis of the respiratory epithelium. Here, we focus on the epidemiology, progression, and biomarkers of COPD with a particular connection to lung cancer. Dissecting the cellular and molecular players in the progression of the disease, we aim to shed light on the role of smoking, which is responsible for the disease, or at least for the more severe symptoms and worse patient outcomes. We summarize the inflammatory conditions, as well as the role of EMT and fibroblasts in establishing a cancer-prone microenvironment, i.e., the soil for ‘COPD-derived’ lung cancer. We highlight that the major health problem of COPD can be alleviated via smoking cessation, early diagnosis, and abandonment of the usage of biomass fuels on a global basis. Full article

(This article belongs to the Special Issue Living with Chronic Obstructive Pulmonary Disease)

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