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. 2013 Jun;10(3):324-32.
doi: 10.3109/15412555.2012.744963.

Impact of co-morbidities on self-rated health in self-reported COPD: an analysis of NHANES 2001-2008

Nirupama Putcha  1 , Milo A Puhan, Nadia N Hansel, M Brad Drummond, Cynthia M Boyd
Affiliations

Impact of co-morbidities on self-rated health in self-reported COPD: an analysis of NHANES 2001-2008

Nirupama Putcha et al. COPD. 2013 Jun.

Abstract

Chronic Obstructive Pulmonary Disease (COPD) coexists with co-morbidities. While co-morbidity has been associated with poorer health status, it is unclear which conditions have the greatest impact on self-rated health. We sought to determine which, and how much, specific co-morbid conditions impact on self-rated health in current and former smokers with self-reported COPD. Using the 2001-2008 National Health and Nutrition Examination Survey we characterized the association between thirteen co-morbidities and health status among individuals self-reporting COPD. Adjusted odds ratios (ORs) were generated using ordinal logistic regression. Additionally we evaluated the impact of increasing number of co-morbidities with self-rated health. Eight illnesses had significant associations with worse self-rated health, however after mutually adjusting for these conditions, congestive heart failure (OR 3.07, 95% CI 1.69-5.58), arthritis (OR 1.69, 95% CI 1.13-2.52), diabetes (OR 1.63, 95% CI 1.01-2.64), and incontinence/prostate disease (OR 1.63, 95% CI 1.01-2.62) remained independent predictors of self-rated health. Each increase in co-morbidities was associated with a 43% higher chance of worse self-rated health (95% CI 1.27-1.62). Individuals with COPD have a substantial burden of co-morbidity, which is associated with worse self-rated health. CHF, arthritis, diabetes and incontinence/prostate disease have the most impact on self-rated health. Targeting these co-morbidities in COPD may result in improved self-rated health.

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Conflict of interest statement

Declaration of Interest Statement

The authors have no financial, consulting, or personal relationships with people or organizations to disclose that could influence the work outlined above.

Figures

Figure 1
Figure 1
Histogram of co-morbidity count (range 0–13) among individuals 45 years of age and older with self-reported COPD.
Figure 2
Figure 2
Odds Ratios for worse self-rated health by co-morbid condition, adjusted for age, gender and race.
Figure 3
Figure 3
Probability of worse self-rated health (fair or poor versus good, very good, or excellent) by co-morbidity count, adjusted for age, gender, and race using logistic regression.
See this image and copyright information in PMC

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