Relationship Between Various Obstructive Lung Diseases
Key Points
Classical Obstructive Lung Diseases, Such as Chronic Obstructive Pulmonary Disease and Asthma, May or May Not Demonstrate Obstruction
Obstruction (with Wheezing, etc) Can Also Be Variably Present in Other Airway and Lung Diseases
Epidemiology
Prevalence
COPD is the 3rd Leading Cause of Death in the US (2009 Data)
COPD Accounted for 133,965 Deaths in 2009
2011 Data: approximately 12.7 million adults in the US had COPD
Approximately 24 Million US Adults Have Evidence of Impaired Lung Function: suggests that COPD is underdiagnosed
Cost
COPD-Related Health Care Utilization (2009 Data)
8 Million Office Visits
1.5 Million Emergency Department Visits
715,000 Hospitalizations
Costs Due to COPD
Approximately $49.9 billion: $29.5 billion in direct health-care expenditures, $8.0 billion in indirect morbidity costs, and $12.4 billion in indirect mortality costs
COPD Exacerbations Account for Most of the Morbidity, Mortality, and Costs Associated with COPD
COPD Exacerbations Cause Frequent Hospital Admissions/Relapses/Readmissions, Contribute to Death During Hospitalization or Shortly Thereafter, Significantly Decrease Quality of Life, Expend Financial Resources, and Accelerate a Progressive Decline in Pulmonary Function
Risk Factors for Chronic Obstructive Pulmonary Disease (COPD)
HIV Infection Accelerates the Onset of Smoking-Related Emphysema (see Human Immunodeficiency Virus, [[Human Immunodeficiency Virus]])
In a Population-Based Study Using Ontario’s Health Administration Database of Patients Diagnosed with COPD Between 1996-2015, the Rate of COPD was Higher in HIV-Positive Patients, as Compared to HIV-Negative Patients (10.4 vs 9.0 Cases Per 1000 Person-Years; Standardized Incidence ratio 1.16, 95% Confidence Interval 1.10 to 1.21; Adjusted Rate Ratio 1.34, 95% CI 1.27 to 1.41) (CMAJ Open, 2020) [MEDLINE]
In a Sensitivity Analysis, Smoking Explained the Observed Differences in COPD Incidence
Inflammatory Bowel Disease (IBD) (see Inflammatory Bowel Disease, [[Inflammatory Bowel Disease]]): chronic bronchitis is associated with UC
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Positive Family History of COPD (Chest, 2011) [MEDLINE]
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Poverty
Clearly a risk factor for COPD, but exact contributors are unclearB
Toxins/Chemicals
Chronic Hydrocarbon Inhalant Abuse (see Hydrocarbons): associated with panacinar emphysema