Asthma-Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study

The association between asthma-chronic obstructive pulmonary diseases (COPD) overlap syndrome (ACOS) and tuberculosis (TB) has yet to be studied. The newly diagnosed TB patients (age > 20 y) treated from January 2000 to December 2008 were included (ACOS cohort, n = 10 751; non-ACOS cohort, n = 42...

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Veröffentlicht in:PloS one 2016-07, Vol.11 (7), p.e0159012-e0159012
Hauptverfasser: Yeh, Jun-Jun, Wang, Yu-Chiao, Kao, Chia-Hung
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description The association between asthma-chronic obstructive pulmonary diseases (COPD) overlap syndrome (ACOS) and tuberculosis (TB) has yet to be studied. The newly diagnosed TB patients (age > 20 y) treated from January 2000 to December 2008 were included (ACOS cohort, n = 10 751; non-ACOS cohort, n = 42 966). The non-ACOS cohort involved patients with confirmed absence of ACOS. We calculated incidence rate ratios (IRRs) for TB in the ACOS and non-ACOS cohorts by using poisson regression analysis. Cox proportional hazards regression models were used to determine the adjusted HR (aHR) for TB in the ACOS cohort compared with the non-ACOS cohort. The aHR for TB was 2.41 (95% confidence interval [CI], 2.19-2.66) in the ACOS cohort. The TB risk was significantly higher in the ACOS cohort than in the non-ACOS cohort when stratified by age, sex, comorbidities, and atopy. Within the ACOS cohort, the aHR was higher among patients receiving SABAs+SAMAs, LABAs+LAMAs, and ICSs (aHR [95% CI]: 3.06 [2.75-3.41], 3.68 [2.93-4.61], and 2.79 [1.25-6.22], respectively; all P < .05). Furthermore, patients with more than 15 outpatient visits and hospitalizations per year demonstrated the highest aHR (8.09; 95% CI, 6.85-9.56). ACOS cohort potentially develop incident TB, regardless of the age,sex, comorbidities and atopy; even without receiving the inhalers.This risk is higher, especially in the ACOS cohort have a high frequency of medical services or receiving the inhalers such as SABAs+SAMAs, LABAs+LAMAs and ICSs.
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ACOS cohort potentially develop incident TB, regardless of the age,sex, comorbidities and atopy; even without receiving the inhalers.This risk is higher, especially in the ACOS cohort have a high frequency of medical services or receiving the inhalers such as SABAs+SAMAs, LABAs+LAMAs and ICSs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0159012</identifier><identifier>PMID: 27448309</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age ; Aged ; Analysis ; Asthma ; Asthma - complications ; Asthma - epidemiology ; Atopy ; Care and treatment ; Chronic obstructive lung disease ; Chronic obstructive pulmonary disease ; Cohort analysis ; Cohort Studies ; Comparative analysis ; Complications and side effects ; Confidence intervals ; Diabetes ; Drug therapy ; Female ; Hazards ; Health insurance ; Health risk assessment ; Health risks ; Health services ; Humans ; Incidence ; Inflammation ; Inhalers ; Lung diseases ; Male ; Medicine and Health Sciences ; Middle Aged ; Mycobacterium ; Obstructive lung disease ; Patients ; Poisson density functions ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Regression analysis ; Regression models ; Risk ; Risk Assessment ; Risk factors ; Sex ; Statistical analysis ; Taiwan - epidemiology ; Tuberculosis ; Tuberculosis, Pulmonary - complications ; Tuberculosis, Pulmonary - epidemiology ; Young Adult</subject><ispartof>PloS one, 2016-07, Vol.11 (7), p.e0159012-e0159012</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Yeh et al. 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The newly diagnosed TB patients (age &gt; 20 y) treated from January 2000 to December 2008 were included (ACOS cohort, n = 10 751; non-ACOS cohort, n = 42 966). The non-ACOS cohort involved patients with confirmed absence of ACOS. We calculated incidence rate ratios (IRRs) for TB in the ACOS and non-ACOS cohorts by using poisson regression analysis. Cox proportional hazards regression models were used to determine the adjusted HR (aHR) for TB in the ACOS cohort compared with the non-ACOS cohort. The aHR for TB was 2.41 (95% confidence interval [CI], 2.19-2.66) in the ACOS cohort. The TB risk was significantly higher in the ACOS cohort than in the non-ACOS cohort when stratified by age, sex, comorbidities, and atopy. Within the ACOS cohort, the aHR was higher among patients receiving SABAs+SAMAs, LABAs+LAMAs, and ICSs (aHR [95% CI]: 3.06 [2.75-3.41], 3.68 [2.93-4.61], and 2.79 [1.25-6.22], respectively; all P &lt; .05). Furthermore, patients with more than 15 outpatient visits and hospitalizations per year demonstrated the highest aHR (8.09; 95% CI, 6.85-9.56). ACOS cohort potentially develop incident TB, regardless of the age,sex, comorbidities and atopy; even without receiving the inhalers.This risk is higher, especially in the ACOS cohort have a high frequency of medical services or receiving the inhalers such as SABAs+SAMAs, LABAs+LAMAs and ICSs.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27448309</pmid><doi>10.1371/journal.pone.0159012</doi><tpages>e0159012</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Age
Aged
Analysis
Asthma
Asthma - complications
Asthma - epidemiology
Atopy
Care and treatment
Chronic obstructive lung disease
Chronic obstructive pulmonary disease
Cohort analysis
Cohort Studies
Comparative analysis
Complications and side effects
Confidence intervals
Diabetes
Drug therapy
Female
Hazards
Health insurance
Health risk assessment
Health risks
Health services
Humans
Incidence
Inflammation
Inhalers
Lung diseases
Male
Medicine and Health Sciences
Middle Aged
Mycobacterium
Obstructive lung disease
Patients
Poisson density functions
Pulmonary Disease, Chronic Obstructive - complications
Pulmonary Disease, Chronic Obstructive - epidemiology
Regression analysis
Regression models
Risk
Risk Assessment
Risk factors
Sex
Statistical analysis
Taiwan - epidemiology
Tuberculosis
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - epidemiology
Young Adult
title Asthma-Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study
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