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

      Highlights

      • 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 65 years, 1/3 of COPD patients and 1/5 of asthmatics might have ACOS.

      Abstract

      Background

      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.

      Methods

      Prevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged >65 years, 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.

      Results

      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.

      Conclusions

      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.

      Abbreviations:

      6MWT (6-min walking test), ACOS (asthma–COPD overlap syndrome), BD (bronchodilator), COPD (chronic obstructive pulmonary disease), GLI (Global Lung Initiative), HRQL (health-related quality of life), LLN (lower limit of normal), PY (person/years), SA.R.A. (SAlute Respiratoria nell'Anziano—Respiratory Health in the Elderly), SGRQ (Saint George Respiratory Questionnaire)

      Keywords

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