Evidence map›Paper›PMID 28166777›Full record

ArticleRespiratory research2017

Associations between chronic comorbidity and exacerbation risk in primary care patients with COPD.

Janine A M Westerik, Esther I Metting, Job F M van Boven, Waling Tiersma, Janwillem W H Kocks, Tjard R Schermer

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  5. Prevalence of osteoarthritis in individuals with COPD: a systematic review.International journal of chronic obstructive pulmonary disease
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  7. Metoprolol for the Prevention of Acute Exacerbations of COPD.The New England journal of medicine · 2019
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  19. A Narrative Review of the Correlation Between Comorbidity and Acute Exacerbation of COPD Patients.International journal of chronic obstructive pulmonary disease · 2026
    Review
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28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Janine A M WesterikDepartment of Primary and Community Care, Radboud University Medical Center, 117-ELG, Geert Grooteplein Noord 21, Nijmegen, 6525 EZ, The Netherlands.
Esther I MettingDepartment of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, HPC FA21, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands.
Job F M van BovenDepartment of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, HPC FA21, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands.
Waling TiersmaDepartment of Primary and Community Care, Radboud University Medical Center, 117-ELG, Geert Grooteplein Noord 21, Nijmegen, 6525 EZ, The Netherlands.
Janwillem W H KocksDepartment of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, HPC FA21, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands.
Tjard R SchermerDepartment of Primary and Community Care, Radboud University Medical Center, 117-ELG, Geert Grooteplein Noord 21, Nijmegen, 6525 EZ, The Netherlands. tjard.schermer@radboudumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCOPD often coexists with chronic conditions that may influence disease prognosis. We investigated associations between chronic (co)morbidities and exacerbations in primary care COPD patients.

methodRetrospective cohort study based on 2012-2013 electronic health records from 179 Dutch general practices. Comorbidities from patients with physician-diagnosed COPD were categorized according to International Classification of Primary Care (ICPC) codes. Chi-squared tests, uni- and multivariable logistic, and Cox regression analyses were used to study associations with exacerbations, defined as oral corticosteroid prescriptions.

resultsFourteen thousand six hundred three patients with COPD could be studied (mean age 67 (SD 12) years, 53% male) for two years. At baseline 12,826 (88%) suffered from ≥1 comorbidities, 3263 (22%) from ≥5. The most prevalent comorbidities were hypertension (35%), coronary heart disease (19%), and osteoarthritis (18%). Several comorbidities showed statistically significant associations with frequent (i.e., ≥2/year) exacerbations: heart failure (odds ratio [OR], 95% confidence interval: 1.72; 1.38-2.14), blindness & low vision (OR 1.46; 1.21-1.75), pulmonary cancer (OR 1.85; 1.28-2.67), depression 1.48; 1.14-1.91), prostate disorders (OR 1.50; 1.13-1.98), asthma (OR 1.36; 1.11-1.70), osteoporosis (OR 1.41; 1.11-1.80), diabetes (OR 0.80; 0.66-0.97), dyspepsia (OR 1.25; 1.03-1.50), and peripheral vascular disease (OR 1.20; 1.00-1.45). From all comorbidity categories, having another chronic respiratory disease beside COPD showed the highest risk for developing a new exacerbation (Cox hazard ratio 1.26; 1.17-1.36).

conclusionChronic comorbidities are highly prevalent in primary care COPD patients. Several chronic comorbidities were associated with having frequent exacerbations and increased exacerbation risk.

Indexed as

AdultAgedAged, 80 and overCohort StudiesComorbidityFemaleHumansMaleMiddle AgedMultiple Chronic ConditionsNetherlandsPrevalencePrimary Health CarePulmonary Disease, Chronic ObstructiveRecurrenceRetrospective Studies

Identifiers

PMID28166777
PMCPMC5294875

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.