Cited by 1,052Chronic Obstructive Pulmonary Disease (COPD) ResearchAsthma and respiratory diseasesSmoking Behavior and Cessation

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Mortality in COPD: role of comorbidities

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Sin, D. D., Anthonisen, N. R., Soriano, J. B., Agusti, A. G.·2006·European Respiratory Journal

DOI 10.1183/09031936.00133805

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Abstract

Chronic obstructive pulmonary disease (COPD) represents an increasing burden throughout the world. COPD-related mortality is probably underestimated because of the difficulties associated with identifying the precise cause of death. Respiratory failure is considered the major cause of death in advanced COPD. Comorbidities such as cardiovascular disease and lung cancer are also major causes and, in mild-to-moderate COPD, are the leading causes of mortality. The links between COPD and these conditions are not fully understood. However, a link through the inflammation pathway has been suggested, as persistent low-grade pulmonary and systemic inflammation, both known risk factors for cardiovascular disease and cancer, are present in COPD independent of cigarette smoking. Lung-specific measurements, such as forced expiratory volume in one second (FEV(1)), predict mortality in COPD and in the general population. However, composite tools, such as health-status measurements (e.g. St George's Respiratory Questionnaire) and the BODE index, which incorporates Body mass index, lung function (airflow Obstruction), Dyspnoea and Exercise capacity, predict mortality better than FEV(1) alone. These multidimensional tools may be more valuable because, unlike predictive approaches based on single parameters, they can reflect the range of comorbidities and the complexity of underlying mechanisms associated with COPD. The current paper reviews the role of comorbidities in chronic obstructive pulmonary disease mortality, the putative underlying pathogenic link between chronic obstructive pulmonary disease and comorbid conditions (i.e. inflammation), and the tools used to predict chronic obstructive pulmonary disease mortality.

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Authors: Sin, D. D., Anthonisen, N. R., Soriano, J. B., & Agusti, A. G.
Affiliations: St. Paul's Hospital (CA)
London School of Hygiene & Tropical Medicine (GB)
ORCID: Sin, D. D.
Soriano, J. B.
Venue: European Respiratory Journal
Publisher: European Respiratory Society (ERS)
Published: 2006-11-30
Volume: 28
Issue: 6
Pages: 1245-1257
ISSN: 0903-1936 (ISSN-L)
1399-3003
DOI: 10.1183/09031936.00133805
OpenAlex: W2118228748
Cited by: 1,052
References: 142
Citations by year: 2026: 22 · 2025: 44 · 2024: 43 · 2023: 40 · 2022: 36 · 2021: 60 · 2020: 61 · 2019: 55 · 2018: 61 · 2017: 63 · 2016: 76 · 2015: 61 · 2014: 77 · 2013: 74 · 2012: 51
FWCI: 7.69
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: European Respiratory Journal (publishedVersion)
PubMed (publishedVersion)
Funders: AstraZeneca
GlaxoSmithKline
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Keywords: chronic obstructive pulmonary disease, COPD mortality, comorbidities, cardiovascular disease, lung cancer, low-grade inflammation, respiratory failure, FEV1, BODE index, St George's Respiratory Questionnaire, mortality prediction, health assessment
MeSH terms: Health Status, Humans, Comorbidity, Pulmonary Disease, Chronic Obstructive

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