List of ICD10-Codes used for comparison of comorbidities and medication.

List of ICD10-Codes used for comparison of comorbidities and medication.

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Objective In large cohort studies comorbidities are usually self-reported by the patients. This way to collect health information only represents conditions known, memorized and openly reported by the patients. Several studies addressed the relationship between self-reported comorbidities and medical records or pharmacy data, but none of them provi...

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Background: Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. Objective: To examine medication access by race/ethnicity among Medicare beneficiaries. Methods: Using the 2013 Medicare Current Beneficiary Survey (n =...

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... Study protocol and assessments of COSYCONET have been described previously 24 . Comorbidities were identified from patients' reports of physician-based diagnoses in combination with disease-specific medication 25 . Inhaled and oral medication was recorded at each visit following a standard procedure 25 www.nature.com/scientificreports/ ...
... Comorbidities were identified from patients' reports of physician-based diagnoses in combination with disease-specific medication 25 . Inhaled and oral medication was recorded at each visit following a standard procedure 25 www.nature.com/scientificreports/ presence of cardiac comorbidities was indicated by a combined variable including heart failure, coronary artery disease and of history of myocardial infarction. ...
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We studied whether in patients with COPD the use of metformin for diabetes treatment was linked to a pattern of lung function decline consistent with the hypothesis of anti-aging effects of metformin. Patients of GOLD grades 1–4 of the COSYCONET cohort with follow-up data of up to 4.5 y were included. The annual decline in lung function (FEV1, FVC) and CO diffusing capacity (KCO, TLCO) in %predicted at baseline was evaluated for associations with age, sex, BMI, pack-years, smoking status, baseline lung function, exacerbation risk, respiratory symptoms, cardiac disease, as well as metformin-containing therapy compared to patients without diabetes and metformin. Among 2741 patients, 1541 (mean age 64.4 y, 601 female) fulfilled the inclusion criteria. In the group with metformin treatment vs. non-diabetes the mean annual decline in KCO and TLCO was significantly lower (0.2 vs 2.3, 0.8 vs. 2.8%predicted, respectively; p < 0.05 each), but not the decline of FEV1 and FVC. These results were confirmed using multiple regression and propensity score analyses. Our findings demonstrate an association between the annual decline of lung diffusing capacity and the intake of metformin in patients with COPD consistent with the hypothesis of anti-aging effects of metformin as reflected in a surrogate marker of emphysema.
... Patients were asked to bring all their medication to the study visit. 29 The presence of comorbidities, including osteoporosis and diabetes, was assessed in a structured interview from patient reports of physician-based diagnoses 4 and supplemented by disease-specific medication. 29 Coronary artery disease, cardiac failure and myocardial infarction were analyzed individually and were also summarized into a combined "cardiac disease" variable. ...
... 29 The presence of comorbidities, including osteoporosis and diabetes, was assessed in a structured interview from patient reports of physician-based diagnoses 4 and supplemented by disease-specific medication. 29 Coronary artery disease, cardiac failure and myocardial infarction were analyzed individually and were also summarized into a combined "cardiac disease" variable. Cardiovascular medication included beta-blockers, renin-angiotensin-aldosterone system inhibitors, angiotensin-receptor antagonists, angiotensin II receptor blockers, calcium-channel blockers and diuretics. ...
... The same was true for other comorbidities, but those other comorbidities could be largely confirmed by analysis of diseasespecific medication. 29 Still, the potential bias from a potentially sex-dependent under-diagnosis of osteoporosis has to be considered. In our study cohort, the prevalence of treatment with ICS and OCS was high as previously described. ...
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Background: Patients with chronic obstructive pulmonary disease (COPD) often have osteoporosis and diabetes as comorbid conditions. Anti-diabetic medication, including metformin, has protective effects on osteoporosis in experimental studies. We therefore studied whether patients with COPD receiving anti-diabetic medication had a lower osteoporosis prevalence in a large COPD cohort, COSYCONET. Methods: Assessment of osteoporosis was based on patients' reports of physician-based diagnoses and the presence of disease-specific medication. The predictive value of physical characteristics, lung function, comorbidities, cardiovascular medication, and the use of anti-inflammatory diabetes medication, including metformin, sulfonylureas, glinides or DPP4I, was evaluated using logistic regression analysis. ClinicalTrials.gov: NCT01245933. Results: In total, 2222 patients were eligible for analysis (863 [39%] female, mean age 65 y), 515 of whom had higher symptoms and exacerbations (Global Initiative for Chronic Obstructive Lung Disease group D). Osteoporosis was present in 15.8% of the overall cohort, and in 24.1% of GOLD D patients. Regression analyses identified the following as associated with osteoporosis (p < 0.05): female sex, higher age, lower body-mass index, asthma, higher air trapping, oral steroids, and cardiovascular medication. Although oral anti-diabetic medication was overall not associated with a lower prevalence of osteoporosis (p = 0.131), anti-inflammatory anti-diabetic medication (p = 0.009) and metformin-containing therapy (p = 0.039) were. This was driven by GOLD D patients. Conclusion: In a large COPD cohort, anti-inflammatory diabetes therapy, including metformin, was associated with a lower prevalence of osteoporosis, especially in patients with higher symptoms and exacerbations. These findings suggest a protective effect of common anti-diabetic medication on osteoporosis, possibly as a result of attenuated systemic inflammation.
... Comorbidities were assessed in structured interviews, whereby additional information on the presence of comorbidities was obtained by the evaluation of disease-specific medication, wherever possible [11,13]. Kidney function was quantified using the estimated glomerular filtration rate (eGFR), based on the creatinine equation from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) [14]. ...
... Considering single CAT items, item 1 (cough) appeared to show different relationships in men and women to age, 6MWD and asthma, item 3 (chest tightness) to asthma and gastrointestinal disorders, item 4 (breathlessness) to reduced TLCO and sleep apnea, item 5 (activities) to age, BMI, reduced TLCO and chronic bronchitis, item 6 (confidence) to age and mental disorder, item 7 (sleeplessness) to sleep apnea and asthma, and item 8 (energy) Absolute numbers and percentages are given. p values refer to the comparison between females and males and were derived from Chi-square statistics *Defined by taking into account disease-specific medication [13] Females ...
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Background In chronic obstructive pulmonary disease (COPD), gender-specific differences in the prevalence of symptoms and comorbidity are known. Research question We studied whether the relationship between these characteristics depended on gender and carried diagnostic information regarding cardiac comorbidities. Study design and methods The analysis was based on 2046 patients (GOLD grades 1–4, 795 women; 38.8%) from the COSYCONET COPD cohort. Assessments comprised the determination of clinical history, comorbidities, lung function, COPD Assessment Test (CAT) and modified Medical Research Council dyspnea scale (mMRC). Using multivariate regression analyses, gender-specific differences in the relationship between symptoms, single CAT items, comorbidities and functional alterations were determined. To reveal the relationship to cardiac disease (myocardial infarction, or heart failure, or coronary artery disease) logistic regression analysis was performed separately in men and women. Results Most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm) and 5 (activities), differed significantly (p < 0.05) between men and women. Beyond this, the relationship between functional parameters and comorbidities versus symptoms showed gender-specific differences, especially for single CAT items. In men, item 8 (energy), mMRC, smoking status, BMI, age and spirometric lung function was related to cardiac disease, while in women primarily age was predictive. Interpretation Gender-specific differences in COPD not only comprised differences in symptoms, comorbidities and functional alterations, but also differences in their mutual relationships. This was reflected in different determinants linked to cardiac disease, thereby indicating that simple diagnostic information might be used differently in men and women. Clinical trial registration The cohort study is registered on ClinicalTrials.gov with identifier NCT01245933 and on GermanCTR.de with identifier DRKS00000284, date of registration November 23, 2010. Further information can be obtained on the website http://www.asconet.net.
... Yet, RAND-36 domain scores were shown to remain relatively stable over a time period of almost 20 years.45 In addition, age-specific domain scores were not available, so domain scores of the overall population (mean age: 43.1) were used for comparisons with the hemophilia cohort.Last, patients tend to underreport co-morbidities.46 This might explain the higher prevalence of hypertension reported by other studies.47,48 ...
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Introduction We conducted six cross-sectional nationwide questionnaire studies among all patients with hemophilia in the Netherlands from 1972 until 2019 to assess how health outcomes have changed, with a special focus on patients >50 years of age. Methods Data were collected on patient characteristics, treatment, (joint) bleeding, joint impairment, hospitalizations, human immunodeficiency virus and hepatitis C infections, and general health status (RAND-36). Results In 2019, 1009 patients participated of whom 48% had mild, 15% moderate and 37% severe hemophilia. From 1972 to 2019, the use of prophylaxis among patients with severe hemophilia increased from 30% to 89%. Their median annual bleeding rate decreased from 25 to 2 bleeds. Patients with severe hemophilia aged <16 years reported joint impairment less often over time, but in those aged > 40 years joint status did not improve. In 2019, 5% of all 1009 patients were positive for the human immunodeficiency virus. The proportion of patients with an active hepatitis C infection drastically decreased from 45% in 2001 to 2% in 2019 due to new anti-hepatitis C treatment options. Twenty-five percent had significant liver fibrosis even after successful therapy. Compared with the general male population, patients aged >50 years reported much lower scores on the RAND-36, especially on physical functioning. Discussion/Conclusion Our study shows that increased use of prophylactic treatment and effective hepatitis C treatment have improved joint health and nearly eradicated hepatitis C infection in patients with hemophilia in the Netherlands. However, patients still suffer from hemophilia-related complications, especially patients aged >50 years.
... Second, an elevated uric acid a level may reflect a comorbidity. A considerable proportion of patients with chronic airway obstruction also suffer from comorbid, systemic inflammatory diseases, such as cardiovascular disease, gout, or metabolic syndrome 45 . It is thus possible that an underlying condition may increase uric acid production. ...
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We performed a retrospective cohort study of 19,237 individuals who underwent at least three health screenings with follow-up periods of over 5 years to find a routinely checked serum marker that predicts lung function decline. Using linear regression models to analyze associations between the rate of decline in the forced expiratory volume in 1 s (FEV1) and the level of 10 serum markers (calcium, phosphorus, uric acid, total cholesterol, total protein, total bilirubin, alkaline phosphatase, aspartate aminotransferase, creatinine, and C-reactive protein) measured at two different times (at the first and third health screenings), we found that an increased uric acid level was significantly associated with an accelerated FEV1 decline (P = 0.0014 and P = 0.037, respectively) and reduced FEV1 predicted % (P = 0.0074 and P = 8.64 × 10 –7 , respectively) at both visits only in non-smoking individuals. In addition, we confirmed that accelerated forced vital capacity (FVC) and FEV1/FVC ratio declines were observed in non-smoking individuals with increased serum uric acid levels using linear mixed models. The serum uric acid level thus potentially predicts an acceleration in lung function decline in a non-smoking general population.
... We believe that these measures minimised any potential bias. Furthermore, the current study examined only physician-diagnosed comorbidities, whereas most previous comorbidity studies used self-reported data, which may limit their internal validity [4,31,32]. This is a population-based study, and our study findings only apply to this set of population. ...
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Background It is difficult to assess the impact of multiple comorbidities on clinical outcomes in chronic obstructive pulmonary disease (COPD). In this study, we aimed to investigate exacerbation-associated comorbidities, determine whether the number of comorbidities is an independent risk factor for exacerbation, and identify other exacerbation-associated factors in a Korean COPD population using a nationwide population-based cohort. This study focused on severe exacerbations that required hospitalisation or emergency room visits. Methods The National Health Insurance Service-National Sample Cohort, version 2.0, data sampled between 2002 and 2015 were analysed. Data from two years after the diagnosis of COPD were analysed for each participant (N = 12,554, entire cohort). Moreover, 42% of the participants underwent additional health examinations (N = 5306, health-screening cohort). Fifteen comorbidities that were previously reported as risk factors for exacerbations were examined. A logistic regression model was used to analyse association with exacerbations. Results Asthma (1.57 [1.39–1.76] and 1.24 [1.06–1.44]), lung cancer (1.84 [1.30–2.59] and 2.28 [1.54–3.37]), and heart failure (1.39 [1.16–1.67] and 1.52 [1.18–1.97]) were associated with exacerbation in both cohorts (odds ratio [95% confidence interval] in the entire cohort and health-screening cohort, respectively). The number of comorbidities was an independent risk factor, and old age, male sex, low body mass index, and current smoking were also independent risk factors. High cholesterol levels and body mass index exerted protective effects against exacerbation. Conclusions The number of comorbidities, certain comorbidities such as asthma, lung cancer and heart failure, and low BMI were associated with an increased risk of severe exacerbation in COPD patients.
... 21 The identification of comorbidities was based on patients' reports of physician-based diagnoses, combined with the intake of disease-specific medication. 22 Lung function assessments obeyed established guidelines. [23][24][25] The measures comprised forced expiratory volume in one second (FEV 1 ), forced vital capacity (FVC) and their ratio (FEV 1 /FVC) from spirometry, moreover diffusing capacity for carbon monoxide (CO) in terms of transfer factor (TLCO) and transfer coefficient (KCO), moreover intrathoracic gas volume (ITGV), residual volume (RV), total lung capacity (TLC) and the ratio RV/TLC from body plethysmography. ...
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Background: In COPD patients of GOLD groups A and B, a high degree of treatment with inhaled corticosteroids (ICS) has been reported, which is regarded as overtreatment according to GOLD recommendations. We investigated which factors predict ICS use and which relationship it has to clinical and functional outcomes, or healthcare costs. Methods: We used pooled data from visits 1 and 3 of the COSYCONET cohort (n=2741, n=2053, interval 1.5 years) including patients categorized as GOLD grades 1-4 and GOLD group A or B at both visits (n=1080). Comparisons were performed using ANOVA, and regression analyses using propensity matching and inverse probability weighting to adjust for differences between ICS groups. These were defined as having ICS at both visits (always) vs no ICS at both visits (never). Measures were divided into predictors of ICS treatment and outcomes. Results: Among 1080 patients, 608 patients were eligible for ICS groups (n=297 never, n=311 always). Prior to matching, patients with ICS showed significantly (p<0.05 each) impaired lung function, symptoms and exacerbation history. After matching, the outcomes generic quality of life and CO diffusing capacity were increased in ICS patients (p<0.05 each). Moreover, costs for respiratory medication, but not total health care costs, were significantly elevated in the ICS group by 780€ per year. Conclusion: ICS therapy in COPD GOLD A/B patients can have small positive and negative effects on clinical outcomes and health care costs, indicating that the clinical evaluation of ICS over-therapy in COPD requires a multi-dimensional approach.
... However, data from NHANES III describe, that 6.6% of participants with a spirometric diagnosis of COPD were in fact never-smokers. 1 Other population-based data including the international BOLD survey even demonstrated a never-smoking proportion among COPD of up to 23%. 2,3 Several other risk factors for COPD beyond smoking have been described. More than 80% of households in China, India and sub-Saharan Africa use biomass for cooking, and in rural areas of Latin America this proportion ranges between 30% and 75%, with a significant impact on death from COPD. 4 In industrialized countries other COPD risk factors like workplace exposures, 2,3 recurrent lower respiratory tract infections, low birth weight, bronchial asthma, history of tuberculosis [5][6][7] and low socioeconomic status 8 have been identified. ...
... As early as 1987, a comparative analysis of Finnish farmers and non-farmers showed that a higher proportion of farmers (2-7%) than non-farmers (0-7%) had COPD, independent of smoking 9 and has been replicated since then. 3 The relative contribution of these factors may differ from country to country, particularly regarding socioeconomic status. 10 A proper population for comparison might be patients with exposure to a definite risk factor over a sufficient period of time, which has stopped, so that acute, potentially disturbing effects are no more present. This could be ex-smokers for a long time with a certain minimum amount of smoking. ...
... Household equivalent income was calculated as the net household income per month divided by the number of persons living in the household weighted by age groups. 2 The presence of comorbidities was determined based on patients' reports of physician-based diagnoses, including data on the intake of disease-specific medication. 3 Patients were asked to bring all their medication to the study visit, which was categorized as previously described. 3,4 Lung function was assessed following the standard operating procedures of COSYCONET, which align with guidelines. ...
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Background: Beyond smoking, several risk factors for the development of chronic obstructive pulmonary disease (COPD) have been described, among which socioeconomic status including education is of particular interest. We studied the contribution of education to lung function and symptoms relative to smoking in a group of never-smokers with COPD compared to a group of long-time ex-smokers with COPD. Methods: We used baseline data of the COSYCONET cohort, including patients of GOLD grades 1-4 who were either never-smokers (n=150, age 68.5y, 53.3% female) or ex-smokers (≥10 packyears) for at least 10 years (n=616, 68.3y, 29.9% female). Socioeconomic status was analyzed using education level and mortality was assessed over a follow-up period of 4.5 years. Analyses were performed using ANOVA and regression models. Results: Spirometric lung function did not differ between groups, whereas CO diffusing capacity and indicators of lung hyperinflation/air-trapping showed better values in the never-smoker group. In both groups, spirometric lung function depended on the education level, with better values for higher education. Quality of life and 6-MWD were significantly different in never-smokers as well as patients with higher education. Asthma, alpha-1-antitrypsin deficiency, and bronchiectasis were more often reported in never-smokers, and asthma was more often reported in patients with higher education. Higher education was also associated with reduced mortality (hazard ratio 0.46; 95% CI 0.22-0.98). Conclusion: Overall, in the COSYCONET COPD cohort, differences in functional status between never-smokers and long-time ex-smokers were not large. Compared to that, the dependence on education level was more prominent, with higher education associated with better outcomes, including mortality. These data indicate that non-smoking COPD patients' socioeconomic factors are relevant and should be taken into account by clinicians.
... However, the participants were asked whether a doctor had diagnosed their condition, and this could have minimised inaccuracy and recall bias. Information on comorbidities given by the patients has been described to be reliable especially for chronic conditions such as diabetes or heart disease (42) . Further studies should be conducted on the incidence of PD, UDD and DD, and their determinants. ...
Article
Objective: To analyse differences in the prevalence of prediabetes (PD), undiagnosed diabetes (UDD) and diagnosed diabetes (DD) and associated factors between Brazilian and English older adults. Design: Cross-sectional study. Setting: England and Brazil. Participants: 5301 participants of the English Longitudinal Study of Ageing study and 1947 participants of the Brazilian Longitudinal Study of Aging study classified as non-diabetics, PD, UDD and DD. Results: The prevalence of PD, UDD and DD was 48·6, 3 and 9·6 % in England and 33, 6 and 20 % in Brazil. In England, the increase in age, non-white skin colour, smoking, general obesity and abdominal obesity were associated with PD, UDD and DD, whereas hypertriglyceridaemia, low HDL levels, hypertension and stroke were associated with UDD and DD. In Brazil, the increase in age was associated with DD and UDD, non-white skin colour and smoking were associated with UDD and abdominal obesity and hypertriglyceridaemia were associated with all three conditions. CVD in England and schooling in Brazil were associated with PD and DD. A sedentary lifestyle was associated with DD in both samples. Conclusions: The prevalence of diabetes was higher in the Brazilian sample. Different associated factors were found in the two samples, which may be related to differences in nutritional transition, access to healthcare services and the use of such services.
... The analysis is not randomized and as a result observational and hypothesis generating. Moreover, the comorbidities are derived from the patients' reports; however, there is a high concordance of reports with disease-specific medication in COSYCONET [44]. On the other hand, our study has a large number of 2218 patients with more detailed information on comorbidities than many previous studies not focused on comorbid conditions. ...
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High resting heart rate (RHR) is associated with higher mortality in the general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). In particular, the time-updated RHR (most recent value before the event) appears informative. This is the first study to investigate the association of time-updated RHR with mortality in COPD. We compared the baseline and time-updated RHR related to survival in 2218 COPD patients of the German COSYCONET cohort (COPD and Systemic Consequences—Comorbidities Network). Patients with a baseline RHR > 72 beats per minute (bmp) had a significantly (p = 0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00–1.87) compared to baseline RHR ≤ 72 bpm. The time-updated RHR > 72 bpm was markedly superior (HR 1.79, 1.30–2.46, p = 0.001). Both, increased baseline and time-updated RHR, were independently associated with low FEV1, low TLCO, a history of diabetes, and medication with short-acting beta agonists (SABAs). In conclusion, increased time-updated RHR is associated with higher mortality in COPD independent of other predictors and superior to baseline RHR. Increased RHR is linked to lung function, comorbidities and medication. Whether RHR is an effective treatment target in COPD, needs to be proven in controlled trials.