Clinical Characteristics and Changes of Clinical Features in Patients with Asthma-COPD Overlap in Korea according to Different Diagnostic Criteria

Tuberculosis and Respiratory Diseases

article

Jeong Uk Lim¹  Deog Kyeom Kim²  Myung Goo Lee³  Yong-Il Hwang⁴  Kyeong-Cheol Shin⁵  Kwang Ho In⁶  Sang Yeub Lee⁷  Chin Kook Rhee⁸  Kwang Ha Yoo⁹  Hyoung Kyu Yoon¹ 

[1] Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center;Division of Pulmonary, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine;Division of Pulmonary, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine;Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine;Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine;Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine;Division of Pulmonary, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Department of Internal Medicine, Konkuk University School of Medicine

关键词: Asthma;    Chronic Obstructive Lung Disease;    Pulmonary Function;   

DOI  :  10.4046/trd.2020.0031

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

Background Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a condition characterized by the overlapping clinical features of asthma and COPD. To evaluate the appropriateness of different sets of ACO definition, we compared the clinical characteristics of the previously defined diagnostic criteria and the specialist opinion in this study. Methods Patients enrolled in the KOrea COpd Subgroup Study (KOCOSS) were evaluated. Based on the questionnaire data, the patients were categorized into the ACO and non-ACO COPD groups according to the four sets of the diagnostic criteria. Results In total 1,475 patients evaluated: 202 of 1,475 (13.6%), 32 of 1,475 (2.2%), 178 of 1,113 (16.0%), and 305 of 1,250 (24.4%) were categorized as ACO according to the modified Spanish Society of Pneumonology and Thoracic Surgery (SEPAR), American Thoracic Society (ATS) Roundtable, Global Initiative for Asthma (GINA)/Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and the specialists diagnosis, respectively. The ACO group defined according to the GINA/GOLD criteria showed significantly higher St. George's Respiratory Questionnaire and COPD Assessment Test scores than the non-ACO COPD group. When the modified SEPAR definition was applied, the ACO group showed a significantly larger decrease in the forced expiratory volume in 1 second (FEV 1 , %). The ACO group defined by the ATS Roundtable showed significantly larger decrease in the forced vital capacity values compared to the non-ACO COPD group (-18.9% vs. -2.2%, p=0.007 and -412 mL vs. -17 mL, p=0.036). The ACO group diagnosed by the specialists showed a significantly larger decrease in the FEV 1 (%) compared to the non-ACO group (-5.4% vs. -0.2%, p=0.003). Conclusion In this study, the prevalence and clinical characteristics of ACO varied depending on the diagnostic criteria applied. With the criteria which are relatively easy to use, defining ACO by the specialists diagnosis may be more practical in clinical applications.

【 授权许可】

CC BY-NC