Anemia in chronic obstructive pulmonary disease: epidemiology and economic implications
Anemia in chronic obstructive pulmonary disease: epidemiology and economic implications
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慢性阻塞性肺疾病贫血：流行病学和经济影响
DOI：
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发表时间：
2008
影响因子：
2.3
通讯作者：
M. Zilberberg
中科院分区：
文献类型：
--
作者：
A. Shorr;J. Doyle;L. Stern;M. Dolgitser;M. Zilberberg
摘要背景：慢性病贫血与医疗资源利用（HRU）和成本增加有关。在COPD中，它经常发生并影响临床和经济结果。由于尚未在单个中心或COPD患者亚群中进行数据研究，因此贫血对结果的影响尚未完全了解。研究设计和方法：我们在大型医疗保健数据库中进行了一项回顾性队列研究，以量化COPD患者贫血的患病率、HRU和成本。从1997年至2005年，纳入了年龄≥ 45岁、ICD-9诊断代码为COPD且随访时间> 3.5年的患者。贫血的定义符合WHO标准。排除了贫血是已知并发症的其他疾病状态。我们计算了贫血的患病率，并比较了COPD伴和不伴贫血患者的年HRU和费用。多元回归分析校正了年龄、性别、种族、入组时间、诊断医师专业、合并症负担、贫血和COPD严重程度的影响。结果：在2404例COPD患者中，33%（n = 788）诊断为贫血。贫血患者年龄较大，更可能是男性和非高加索人，并且比非贫血个体有更大的合并症负担。COPD合并贫血患者的年度费用是无贫血患者的两倍多（17240美元对6492美元，p < 0.001，未调整）。贫血COPD患者的HRU也显著高于非贫血COPD患者（p < 0.0001）。在多元回归分析中，贫血占每例患者7929美元（95%CI：5572 - 10599美元）的总护理费用。局限性：这是一项回顾性队列研究，因此存在多种形式的偏倚。虽然COPD的肺量测定证据仅适用于一个亚组的患者，但我们的病例识别方法先前已经过验证，发现在识别COPD方面是准确的。结论：贫血是COPD常见的合并症。它与HRU增加和COPD护理成本显著相关，与人口统计学和临床患者特征无关。
ABSTRACT Background: Anemia in chronic illness is associated with increased healthcare resource utilization (HRU) and costs. In COPD, it occurs frequently and influences both clinical and economic outcomes. Because no data studies have been performed either in a single center or a subpopulation of COPD patients, anemia's influence on the outcomes is not fully understood. Research design and methods: We conducted a retrospective cohort study in a large healthcare database to quantify prevalence, HRU and costs of anemia in COPD. From 1997 to 2005, patients ≥ 45 years of age with an ICD-9 diagnosis code for COPD and > 3.5 years of follow-up were included. Anemia was defined by the WHO criteria. Other disease states for which anemia is a known complication were excluded. We calculated the prevalence of anemia and compared annual HRU and costs between COPD patients with and without anemia. Multiple regression analysis adjusted for the effects of age, gender, race, length of enrollment, diagnosing physician specialty, co-morbidity burden, anemia and COPD severity. Results: Of the 2404 patients with COPD, 33% (n = 788) had a diagnosis of anemia. Anemic patients were older, more likely to be male and non-Caucasian, and had a greater co-morbidity burden than non-anemic individuals. Annual costs for COPD patients with anemia were more than twice those for patients without anemia ($17 240 vs. 6492, p < 0.001, unadjusted). HRU was also significantly greater among anemic than non-anemic COPD patients ( p < 0.0001). In a multiple regression analysis, anemia accounted for $7929 per patient (95% CI: $5572–10 599) of the total costs of care. Limitations: This is a retrospective cohort study and thus subject to multiple forms of bias. Although spirometric evidence of COPD was available only for a subgroup of patients, our case identification methods have been previously validated and found to be accurate in recognizing COPD. Conclusions: Anemia is a common co-morbidity in COPD. It is significantly associated with an increase in HRU and costs of care for COPD, independent of demographic and clinical patient characteristics.
预测治疗慢性阻塞性肺病患者的费用。
影响因子：
4.3
作者：
Mapel,DouglasW;McMillan,GarnettP;Frost,FloydJ;Hurley,JudithS;Picchi,MariaA;Lydick,Eva;Spencer,MichaelD
通讯作者：
Spencer,MichaelD