Comorbidity, variable obstruction and COPD. A problem with many unknowns?

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the frequent diseases that most multimorbid patients have and, in turn, is one of the most important comorbid conditions that negatively affects the outcomes of other diseases. Aim: Study of comorbid conditions in respondents with COPD and variable obstruction aged 35 to 70 years, residents of two cities in the NorthWest region of Russia Materials and methods . Cohort study with variable obstruction (n=90) and COPD patients (n=53) identified at the population phase of the RESPECT study was performed. Demographic data and risk factors were studied, spirometry with bronchodilator test were performed. Comorbidity was considered using the modified Charlson index, quality of life was assessed. Results and discussion . The mean age of the participants was 57.5±8.2 years, and did not differ between those with variable obstruction and COPD. Respondents with COPD were predominantly male (79.2% vs 43.3%), ever smokers (94.3% vs 67.4%); this group had a higher proportion of individuals with severe symptoms. The proportion of persons with high risk of exacerbations was equally low in both groups. The most common comorbidity was arterial hypertension (56.3%). The frequency of comorbidity and the level of comorbidity index did not differ between the two groups. The modified comorbidity index was associated with the number of years of smoking (β=0.025, p=0.034), anxiety and depression (β=0.092, p=0.009). More than half of those with COPD and variable obstruction were multimorbid (52.8% and 53.3%, p>0.05). Self-assessed quality of life worsened with age (β=0.027, p=0.045), was associated with multimorbidity (β=0.80, p=0.000), was not dependent on gender, and did not differ between respondents with COPD and those with variable obstruction. Conclusion . Comorbidity should be assessed not only in individuals with COPD, but also in individuals with variable obstruction with mutual risk factors.