Heart failure and chronic obstructive pulmonary disease (COPD) often coexist in patients. COPD is often caused by smoking and is characterised by shortness of breath. Patients with COPD often experience acute (sudden) worsening of symptoms, usually due to infections with viruses or bacteria, and these are termed exacerbations. How exacerbations and their triggers affect comorbidities (diseases that coexist in a patient), such as heart failure, is likely to differ not only with different triggers, but also with the severity of the underlying COPD. Understanding the current situation with respect to the diagnosis and management of heart failure in COPD patients may impact the number and severity of exacerbations experienced by patients by highlighting areas in which care can be improved.
Heart failure and chronic obstructive pulmonary disease (COPD) share aetiology, symptoms, and the potential to exacerbate the other condition leading to higher health care utilization costs and mortality in patients with both conditions. Recent international guidelines have recommended increased consideration of comorbid conditions when assessing COPD and heart failure, demonstrating recognition of the influences of comorbidities on disease progression and prognosis. In this study, we will investigate the incidence of comorbid COPD and heart failure, the effect of comorbid heart failure on acute exacerbations of COPD (AECOPD), and the impact of suboptimal treatment and under-diagnosis of heart failure on AECOPD. This is a cohort study and will calculate incidence and prevalence. Survival analysis (Cox regression) will be used to investigate delayed HF diagnosis and matched cohort analysis (Cox) will be used to compare AECOPD across patient groups.
Incidence of comorbid COPD and HF
Prevalence of comorbid COPD and HF
Rates of AECOPD in relation to comorbid COPD-HF
Jennifer Quint - Chief Investigator - Imperial College London
Eleanor Axson - Corresponding Applicant - Imperial College London
Alex Bottle - Collaborator - Imperial College London
Chloe Bloom - Collaborator - Imperial College London
Martin Cowie - Collaborator - Imperial College London
Varun Sundaram - Collaborator - Imperial College London
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation