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Previous Respiratory Disease & Lung Cancer

Previous Respiratory Disease & Lung Cancer

Studies have suggested a relationship between previous respiratory diseases and a lung cancer diagnosis. Most of this research has been conducted in Asian populations and does not account for the high level of co-occurrence that has been observed among different respiratory diseases. To better understand the relationship between multiple previous respiratory diseases and lung cancer risk, Paolo Boffetta, MD, MPH, and colleagues pooled data from a consortium of seven case-control studies as part of the SYNERGY project, which provided detailed information on smoking habits in European and North American populations. New Findings Data on five previous respiratory diseases—chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma—were collected by self-report for the study, which was published in the American Journal of Respiratory and Critical Care Medicine. Analyses were stratified by gender and adjusted for study center, age, employment in an occupation with an excess risk of lung cancer, level of education, smoking status, cigarette pack-years, and time since quitting smoking. According to the results, patients with chronic bronchitis, emphysema, and pneumonia were at higher risk of lung cancer when compared with those who had no previous respiratory disease diagnoses. In men, chronic bronchitis and emphysema were associated with odds ratios (ORs) of 1.33 and 1.50, respectively, for lung cancer. Men who were diagnosed with pneumonia 2 or fewer years prior to lung cancer were also at greater risk of lung cancer (OR, 3.31), but this correlation leveled off when a pneumonia diagnosis was made after the 2-year threshold. Patients with co-occurring chronic bronchitis, emphysema, and pneumonia had a higher risk of lung cancer than those who had any of these conditions alone....
A Look at Recidivism in COPD Management

A Look at Recidivism in COPD Management

COPD is a group of progressively debilitating respiratory conditions, including emphysema and chronic bronchitis, and it ranks as the third leading cause of death in the United States, according to the CDC. About 16 million Americans are currently diagnosed with COPD, but another 14 million or more remain undiagnosed. In addition, COPD accounts for nearly 2 million ED visits each year, but much of this data is confounded by asthma admissions. “COPD patients who require ED attention or hospitalization are those with the most severe disease,” explains Reynold A. Panettieri, Jr., MD. “Furthermore, hospitalization and ED visits for COPD are more often clustered in the winter. They are associated with exposure to viruses and bacterial pathogens.” People aged 50 and older are more likely than others to get COPD, but the damage starts years before these individuals are diagnosed and can progress even after smoking cessation. Since the disease occurs and is diagnosed later in life, the risk of COPD is especially high for patients older than 45 with a smoking history. Healthcare Utilization & Readmission for COPD Most patients with diagnosed COPD report that symptoms of their disease impair their quality of life, but only about half take at least one daily medication for COPD. The healthcare utilization rate for COPD patients is also substantial. About one in five COPD patients visits an ED or is admitted to a hospital for care within a year. “The bottom line is that patients, providers, and the healthcare system cannot afford recidivism for COPD hospitalization.” Recidivism in healthcare has been defined as the tendency by ill patients to relapse or return...
The Impact of Chronic Lung Disease in MI

The Impact of Chronic Lung Disease in MI

Chronic lung disease (CLD)—including COPD, chronic bronchitis, and emphysema—is common, presenting in approximately one in seven patients presenting with myocardial infarction (MI). Patients with CLD are more likely to die or be hospitalized from cardiovascular disease than from any other disease. Despite this knowledge, few studies have explored the influence of CLD on patient management and outcomes following MI. Gaining a better understanding of this relationship could lead to opportunities for improving quality of care and outcomes for CLD patients. Treatments & Mortality for Chronic Lung Disease In a study published in the American Heart Journal, my colleagues and I utilized the National Cardiovascular Data Registry to determine the association of CLD with treatments and adverse events after MI. Our results showed that CLD patients presenting with non-STEMI had a 20% increased risk for in-hospital death when compared with those who did not have CLD. No such link, however, was found among CLD patients with STEMI. In addition, CLD patients with non-STEMI were markedly less likely to receive invasive procedures, such as cardiac catheterization, PCI, or CABG surgery. They were also slightly less likely to receive evidence-based medical therapies, including thienopyridines, β-blockers, and statins. Conversely, differences in treatment of STEMI patients with CLD were not clinically significant, according to findings in our investigation. Taking a Closer Look at Bleeding Risks This is also the first study to our knowledge indicating that, independent of other factors, CLD patients had a 20% to 25% higher risk of bleeding when compared with those without CLD. Major bleeding is one of the most common in-hospital complications following acute coronary syndromes and is associated...
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