Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 16;12(3):e0173830.
doi: 10.1371/journal.pone.0173830. eCollection 2017.

Concurrent physician-diagnosed asthma and chronic obstructive pulmonary disease: A population study of prevalence, incidence and mortality

Tetyana Kendzerska  1   2   3   4 , Mohsen Sadatsafavi  5 , Shawn D Aaron  1 , Teresa M To  3   4   6   7 , M Diane Lougheed  8 , J Mark FitzGerald  5 , Andrea S Gershon  3   4   6   7   9 ; Canadian Respiratory Research Network
Affiliations

Concurrent physician-diagnosed asthma and chronic obstructive pulmonary disease: A population study of prevalence, incidence and mortality

Tetyana Kendzerska et al. PLoS One. .

Abstract

Objective: We conducted a population-based cohort study to estimate trends in prevalence, incidence, and mortality of concurrent physician-diagnosed asthma and chronic obstructive pulmonary disease (COPD).

Study design and setting: Two validated health administrative case definitions were used to identify asthma and COPD among all individuals aged 35 years and older living in Ontario, Canada. Annual asthma, COPD, and concurrent asthma and COPD prevalence, incidence, and mortality, standardized for age and sex, were estimated, and compared from 2002 to 2012, using generalized linear models.

Results: Standardized prevalence of concurrent asthma and COPD increased by 10.5%, from 2.9% in 2002 to 3.2% in 2012 overall, but more prominently in women compared to men. Overall, standardized incidence decreased by16%, from 2.5 to 2.1 per 1000 individuals, but increased significantly in young adults. All-cause mortality among patients with concurrent asthma and COPD decreased by 11.2%, from 2.6% to 2.2%. Being diagnosed with both diseases was significantly associated with higher all-cause mortality compared to asthma (OR = 1.56, 95% CI: 1.50-1.58), but not compared to COPD (OR = 0.97, 0.96-0.98), except in young adults aged 35 to 49 years where people with asthma and COPD had higher mortality (OR = 1.21, 1.15-1.27).

Conclusions: In a large North American population, the burden of concurrent physician-diagnosed asthma and COPD is increasing, particularly in women and young adults.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The Canadian Respiratory Research Network (CRRN) is supported by grants from the Canadian Institutes of Health Research - Institute of Circulatory and Respiratory Health; Canadian Lung Association/ Canadian Thoracic Society; British Columbia Lung Association; and Industry Partners Boehringer-Ingelheim Canada Ltd, AstraZeneca Canada Inc., and Novartis Canada Ltd. Dr. Kendzerska is supported by the CRRN Fellowship Training Award which was supported by the above funding Sponsors and as well by GlaxoSmithKline Inc. Dr. Lougheed has received research funding not related to this study paid directly to Queen’s University from GlaxoSmithKline, Janssen and Hoffmann LaRoche. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Age and sex standardized prevalence rates (%) for COPD, asthma and concurrent physician-diagnosed asthma and COPD over time among adults 35 years and older in Ontario, Canada.
Fig 2
Fig 2. Age and sex standardized incidence rates (per 1000 individuals) for COPD, asthma and concurrent physician-diagnosed asthma and COPD over time among adults 35 years and older in Ontario, Canada.
Fig 3
Fig 3. All-cause mortality standardized rates (%) by age and sex for COPD, asthma and concurrent physician-diagnosed asthma and COPD over time among adults 35 years and older in Ontario, Canada.
See this image and copyright information in PMC

References

    1. Diagnosis of Diseases of Chronic Airflow Limitation: Asthma, COPD and Asthma-COPD Overlap Syndrome (ACOS), (2014).
    1. Global Initiative for Asthma. 2015 Asthma, COPD and asthma-COPD overlap syndrome (ACOS). Global Initiative for Asthma website: http://ginasthma.org/asthma-copd-and-asthma-copd-overlap-syndrome-acos/ [cited 2017 Jan 6, 2017].
    1. Hardin M, Cho M, McDonald ML, Beaty T, Ramsdell J, Bhatt S, et al. The clinical and genetic features of COPD-asthma overlap syndrome. The European respiratory journal. 2014;44(2):341–50. Epub 2014/05/31. PubMed Central PMCID: PMC4154588. 10.1183/09031936.00216013 - DOI - PMC - PubMed
    1. Hardin M, Silverman EK, Barr RG, Hansel NN, Schroeder JD, Make BJ, et al. The clinical features of the overlap between COPD and asthma. Respiratory research. 2011;12:127 Epub 2011/09/29. PubMed Central PMCID: PMC3204243. 10.1186/1465-9921-12-127 - DOI - PMC - PubMed
    1. Menezes AM, Montes de Oca M, Perez-Padilla R, Nadeau G, Wehrmeister FC, Lopez-Varela MV, et al. Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma. Chest. 2014;145(2):297–304. Epub 2013/10/12. 10.1378/chest.13-0622 - DOI - PubMed