Asthma, COPD and the Risk of Respiratory‑related Death

Pavankumar Kamat

Disclosures

January 20, 2022

Takeaway

  • Physician-diagnosed adult-onset asthma and chronic obstructive pulmonary disease (COPD) were associated with an increased risk of respiratory-related death.

  • The 10-year probability of a respiratory-related death was much higher in patients with COPD than in those with asthma.

  • Asthma-COPD overlap (ACO) was associated with a higher risk of respiratory-related death compared with asthma alone, but not COPD alone.

Why this matters

  • Findings highlight the need for effective interventions in people with a diagnosis of COPD to reduce their lifetime excess respiratory mortality risk.

Study design

  • A matched cohort study used data from the UK Clinical Practice Research Datalink GOLD database and Office for National Statistics mortality database (2005-2015).

  • 65,012 patients with asthma and 45,649 with COPD were matched (5:1) with 324,885 participants without asthma and 228,076 without COPD, respectively.

  • Funding: None.

Key results

  • At 10 years post-diagnosis:

    • 14 in 100,000 patients with asthma were predicted to have a respiratory-related death, an excess of 9 per 100,000 (95% CI 0 to 18 in 100,000) compared with the control group.

    • 98 in 100,000 patients with COPD were predicted to have a respiratory-related death, an excess of 67 per 100,000 (95% CI 38 to 95 in 100,000) compared with the control group.

  • Asthma was linked to a 0.01% excess incidence of respiratory-related death, whereas COPD was linked to a 0.07% excess incidence.

  • ACO (n=22,145) was associated with an increased risk of respiratory-related death compared with asthma alone (HR, 1.30; 95% CI 1.21 to 1.40) but not COPD alone (HR, 0.89; 95% CI 0.83 to 0.94).

Limitations

  • Competing causes of death can be misrepresented in the mortality data.

Gayle AV, Minelli C, Quint JK. Respiratory-related death in individuals with incident asthma and COPD: a competing risk analysis. BMC Pulm Med. 2022;22(1):28. doi: 10.1186/s12890-022-01823-4. PMID: 34998380 View Full Text.

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