Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/31069
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    標題: Asthma-Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study
    作者: Yeh, Jun-Jun
    Wang, Yu-Chiao
    Kao, Chia-Hung
    貢獻者: Chia Yi Christian Hosp, Ditmanson Med Fdn
    Chia Nan Univ Pharm & Sci
    Meiho Univ
    China Med Univ Hosp, Management Off Hlth Data
    China Med Univ, Coll Med
    China Med Univ, Coll Med, Grad Inst Clin Med Sci
    China Med Univ Hosp, Dept Nucl Med
    China Med Univ Hosp, PET Ctr
    關鍵字: copd overlap
    inhaled corticosteroids
    syndrome acos
    lung-disease
    taiwan
    exacerbations
    tiotropium
    phenotypes
    stay
    gold
    日期: 2016-07
    上傳時間: 2018-01-18 11:41:03 (UTC+8)
    出版者: Public Library Science
    摘要: Purpose The association between asthma-chronic obstructive pulmonary diseases (COPD) overlap syndrome (ACOS) and tuberculosis (TB) has yet to be studied. Methods 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. Results 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). Conclusions 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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