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Coexisting Respiratory Comorbidities Increase Mortality in Patients with Asthma: A National Cohort Study
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  • Yoomi Yeo,
  • Dong Won Park,
  • Jiin Ryu,
  • Sung Jun Chung,
  • Tai Sun Park,
  • Hyun Lee,
  • Sang-Heon Kim,
  • Jang Won Sohn,
  • Ho-Joo Yoon,
  • Tae-Hyung Kim,
  • Ji-yong MOON
Yoomi Yeo
Hanyang University
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Dong Won Park
Hanyang University
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Jiin Ryu
Hanyang University
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Sung Jun Chung
Hanyang University
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Tai Sun Park
Hanyang University
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Hyun Lee
Hanyang University
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Sang-Heon Kim
Hanyang University
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Jang Won Sohn
Hanyang University
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Ho-Joo Yoon
Hanyang University
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Tae-Hyung Kim
Hanyang University
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Ji-yong MOON
Hanyang University
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Abstract

Background: Asthmatic patients are generally considered to have an increased risk of mortality compared with subjects without asthma. However, this issue has not been fully evaluated using nationally representative data. In addition, it is unclear whether respiratory comorbidities other than chronic obstructive pulmonary disease (COPD) are associated with increased mortality in asthmatic patients compared with subjects without asthma. Methods: Using a nationally representative sample database, we performed a retrospective cohort study of patients with asthma and age- sex-matched control cohort. We estimated hazard ratio (HR) and 95% confidence interval (CI) for mortality. We also stratified the asthma cohort based on respiratory comorbidities. Results: During a median 8.9-year follow-up, the overall mortality rate was higher in the asthma cohort than in the control cohort (p < 0.001). The HR for mortality in the asthma cohort compared with the control cohort was 1.13 (95% CI = 1.07–1.19). The effects of asthma on mortality were more evident in males, patients under medical aid, and subjects with COPD. Respiratory comorbidities were significantly associated with increased risk of mortality in asthmatic patients compared with controls (COPD, adjusted HR, aHR = 1.49, 95% CI = 1.39–1.59; bronchiectasis, aHR = 1.43, 95% CI = 1.18–1.73; lung cancer, aHR = 4.11, 95% CI = 2.59–6.52; pneumonia, aHR = 1.59, 95% CI = 1.46–1.74). Conclusion: Patients with asthma had a higher mortality rate compared with subjects without asthma. Coexisting pulmonary comorbidities were the primary cause of higher mortality in patients with asthma