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Clinical Characteristics and Changes of Clinical Features in Patients with Asthma-COPD Overlap in Korea according to Different Diagnostic Criteria

Tuberculosis and Respiratory Diseases 2020년 83권 0호 p.34 ~ 45
임정욱, 김덕겸, 이명구, 황용일, 신경철, 인광호, 이상엽, 이진국, 김순종, 윤형규,
소속 상세정보
임정욱 ( Lim Jeong-Uk ) - Catholic University College of Medicine Yeouido St. Mary’s Hospital Department of Internal Medicine
김덕겸 ( Kim Deog-Kyeom ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Department of Internal Medicine
이명구 ( Lee Myung-Goo ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Internal Medicine
황용일 ( Hwang Yong-Il ) - Hallym University College of Medicine Sacred Heart Hospital Department of Internal Medicine
신경철 ( Shin Kyeong-Cheol ) - Yeungnam University College of Medicine Yeungnam University Medical Center Regional Center for Respiratory Disease
인광호 ( In Kwang-Ho ) - Korea University College of Medicine Department of Internal Medicine
이상엽 ( Lee Sang-Yeub ) - Korea University College of Medicine Anam Hospital Department of Internal Medicine
이진국 ( Rhee Chin-Kook ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
김순종 ( Yoo Kwang-Ha ) - Konkuk University School of Medicine Department of Internal Medicine
윤형규 ( Yoon Hyoung-Kyu ) - Catholic University College of Medicine Yeouido St. Mary’s Hospital Department of Internal Medicine

Abstract


Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a condition characterized by the overlapping clinical features of asthma and COPD. To evaluate the appropriateness of different sets of ACO definition, we compared the clinical characteristics of the previously defined diagnostic criteria and the specialist opinion in this study.

Methods: Patients enrolled in the KOrea COpd Subgroup Study (KOCOSS) were evaluated. Based on the questionnaire data, the patients were categorized into the ACO and non-ACO COPD groups according to the four sets of the diagnostic criteria.

Results: In total 1,475 patients evaluated: 202 of 1,475 (13.6%), 32 of 1,475 (2.2%), 178 of 1,113 (16.0%), and 305 of 1,250 (24.4%) were categorized as ACO according to the modified Spanish Society of Pneumonology and Thoracic Surgery (SEPAR), American Thoracic Society (ATS) Roundtable, Global Initiative for Asthma (GINA)/Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and the specialists diagnosis, respectively. The ACO group defined according to the GINA/GOLD criteria showed significantly higher St. George's Respiratory Questionnaire and COPD Assessment Test scores than the non-ACO COPD group. When the modified SEPAR definition was applied, the ACO group showed a significantly larger decrease in the forced expiratory volume in 1 second (FEV1, %). The ACO group defined by the ATS Roundtable showed significantly larger decrease in the forced vital capacity values compared to the non-ACO COPD group (-18.9% vs. -2.2%, p=0.007 and -412 mL vs. -17 mL, p=0.036). The ACO group diagnosed by the specialists showed a significantly larger decrease in the FEV1 (%) compared to the non-ACO group (-5.4% vs. -0.2%, p=0.003).

Conclusion: In this study, the prevalence and clinical characteristics of ACO varied depending on the diagnostic criteria applied. With the criteria which are relatively easy to use, defining ACO by the specialists diagnosis may be more practical in clinical applications.

키워드

Asthma; Chronic Obstructive Lung Disease; Pulmonary Function

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