• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.157-163
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• 2019

This study determines the difference in prevalence of anemia and hemoglobin concentration between chronic obstructive pulmonary disease (COPD) and control groups in the elderly. Moreover, this study also examines the prevalence of anemia and hemoglobin concentration according to the severity of COPD in the elderly. Medical records of 8150 participants who answered the 7th National Health and Nutritional Survey conducted in 2016 were reviewed, and a total of 694 participants was included in the analysis. Participants were classified into two groups: COPD and control groups. Laboratory studies on hemoglobin, hematocrit, red blood cell concentration and prevalence of anemia were collected. Subgroup analysis was also conducted according to the severity of COPD. No significant differences were determined for the prevalence of anemia and hemoglobin concentration between both groups. Hemoglobin concentration was significantly higher in the COPD group. Although not statistically significant, there was a tendency for decrease in the prevalence of anemia and increase in the hemoglobin concentration as the severity of COPD increased. Our findings present specific data about the prevalence of anemia and hemoglobin concentration in elderly patients with COPD. Hence, we propose that occurrence of anemia in elderly patients with COPD requires further evaluation of the causes.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.474-481
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.26-32
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• 2014

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.

• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.27-34
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• 2019

Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.74-79
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• 2022

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.

• 한국노년학
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• v.31 no.3
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• pp.607-621
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• 2011

Purpose The purpose of this study was to examine the relationship between physical activities, sleep disturbance, and health related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). Methods A descriptive survey design used pretest dataset of COPD symptom management intervention study (N=245). Measures included the international physical activity questionnaire, the COPD and asthma sleep impact scale, and the St. George's respiratory questionnaire of HRQOL. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and simultaneous multiple regression by the SPSS WIN 18.0 program. Results The mean scores (SD) of HRQOL and sleep disturbance were 36.04 (19.43) and 14.33 (6.20), respectively. About 32% of participants were physically inactive. The multivariate approach showed the patients who have more sleep disturbance (β=.27), lower levels of FEV1 % predicted (β=-.23), lower physical activities (β=-.19), lower household income (β=-.16), and diagnosed longer than 5 years (β=.14) reported lower HRQOL (R²=.34). Conclusion The findings of this study suggest that improving the quality of sleep and physical activities can be efficient strategies for HRQOL in patients with COPD. Future research in enhancing HRQOL through improving sleep quality and physical activities is needed.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.328-334
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged ${\geq}45$ years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. Methods: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged ${\geq}40$ years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. Results: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged ${\geq}40$ years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. Conclusion: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.195-201
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• 2011

Background: Osteopontin (Opn) is recognized as an important adhesive bone matrix protein and a key cytokine involved in immune cell recruitment and tissue repair and remolding. However, serum levels of osteopontin have not been evaluated in patients with chronic obstructive pulmonary disease (COPD). Thus, the aim of this study was to evaluate and compare the serum levels of osteopontin in patients experiencing COPD exacerbations and in patients with stable COPD. Methods: Serum samples were obtained from 22 healthy control subjects, 18 stable COPD patients, and 15 COPD with exacerbation patients. Serum concentrations of osteopontin were measured by the ELISA method. Results: Serum levels of osteopontin were higher in patients with acute exacerbation than with stable COPD and in healthy control subjects ($62.4{\pm}51.9ng/mL$, $36.9{\pm}11.1ng/mL$, $30{\pm}11ng/mL$, test for trend p=0.003). In the patients with COPD exacerbation, the osteopontin levels when the patient was discharged from the hospital tended to decrease compared to those at admission ($45{\pm}52.1ng/mL$, $62.4{\pm}51.9ng/mL$, p=0.160). Osteopontin levels significantly increased according to patient factors, including never-smoker, ex-smoker and current smoker ($23{\pm}5.7ng/mL$, $35.5{\pm}17.6ng/mL$, $58.6{\pm}47.8ng/mL$, test for trend p=0.006). Also, osteopontin levels showed a significantly negative correlation with forced expiratory volume in one second ($FEV_1$%) predicted in healthy controls and stable COPD patients (r=-0.389; p=0.013). C-reactive protein (CRP) was positively correlated with osteopontin levels in patients with COPD exacerbation (r=0.775; p=0.002). Conclusion: The serum levels of osteopontin increased in patients with COPD exacerbation and tended to decrease after clinical improvement. These results suggest the possible role of osteopontin as a biomarker of acute exacerbation of COPD.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.37-46
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• 2022

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.