Fifteen-year mortality of patients with asthma–COPD overlap syndrome

• Published in: European journal of internal medicine Vol. 34; pp. 72 - 77
• Main Authors: Sorino, Claudio, Pedone, Claudio, Scichilone, Nicola
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2016
• Subjects: Aged; Aged, 80 and over; Asthma; Asthma - diagnosis; Asthma - epidemiology; Case-Control Studies; Chronic obstructive pulmonary disease; Comorbidity; COPD; Epidemiology; Female; Humans; Internal Medicine; Italy; Kaplan-Meier Estimate; Male; Mortality; Prognosis; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Quality of Life; BD; HRQL; GLI; PY; SA.R.A; 6MWT; Epidemiology; LLN; Asthma; SGRQ; ACOS; Chronic obstructive pulmonary disease; COPD; Global Lung Initiative; SAlute Respiratoria nell'Anziano—Respiratory Health in the Elderly; health-related quality of life; lower limit of normal; Saint George Respiratory Questionnaire; asthma–COPD overlap syndrome; person/years; 6-min walking test; bronchodilator; chronic obstructive pulmonary disease
• ISSN: 0953-6205; 1879-0828; 1879-0828
• DOI: 10.1016/j.ejim.2016.06.020

The coexistence of asthma and chronic obstructive pulmonary disease (asthma–COPD overlap syndrome: ACOS) is increasingly recognized but data about its prevalence and long-term mortality are needed. Prevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged >65years, enrolled in the SA.R.A. study, with complete clinical, lung functional and follow-up data. Physical performance, disease-related disability, and health-related quality of life (HRQL) were also evaluated. ACOS was found in 11.1% of subjects (29.4% of those previously diagnosed with COPD and 19.7% of those with asthma). ACOS was positively associated with impaired physical performance, functional ability, and HRQL. Individuals with ACOS had higher mortality rates than controls (7.17 per 100 person-years; mortality rate ratio: 1.83). After adjustment for the main confounders, the risk of all-cause mortality remained significantly increased in subjects with ACOS (HR: 1.82), COPD (HR: 2.12), and restriction (HR: 2.41), but not asthma. Long-term prognosis of ACOS was similar to COPD, and worse than asthma and healthy controls. ACOS had a significant impact on physical performance, functional ability, and HRQL. •ACOS negatively affects physical performance and health-related quality of life.•ACOS worsens disease-related disability.•Long-term mortality of ACOS is worse than asthma and similar to COPD.•After 65years, 1/3 of COPD patients and 1/5 of asthmatics might have ACOS.