Email updates

Keep up to date with the latest news and content from BMC Pulmonary Medicine and BioMed Central.

Open Access Highly Accessed Research article

Association between chronic obstructive pulmonary disease and gastroesophageal reflux disease: a national cross-sectional cohort study

Jinhee Kim1, Jin Hwa Lee2*, Yuri Kim3, Kyungjoo Kim3, Yeon-Mok Oh4, Kwang Ha Yoo5, Chin Kook Rhee6, Hyoung Kyu Yoon7, Young Sam Kim8, Yong Bum Park9, Sei Won Lee4 and Sang Do Lee4

Author Affiliations

1 Office of Heath Service Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea

2 Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea

3 Department of Clinical Research Support, National Strategic Coordinating Center for Clinical Research, Seoul, Korea

4 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

5 Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea

6 Department of Internal Medicine, Seoul St. Mary’s Hospital, Catholic University of Korea, Seoul, Korea

7 Department of Internal Medicine, Yeouido St. Mary’s Hospital, Catholic University of Korea, Seoul, Korea

8 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

9 Department of Internal Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea

For all author emails, please log on.

BMC Pulmonary Medicine 2013, 13:51  doi:10.1186/1471-2466-13-51

Published: 9 August 2013

Abstract

Background

Gastroesophageal reflux disease (GERD) is one of the most common causes of chronic cough and a potential risk factor for exacerbation of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the prevalence and risk factors of GERD in patients with COPD and association between GERD and COPD exacerbation.

Methods

Data were collected from the National Health Insurance Database of Korea. The subjects were 40 years old and older, who had COPD as primary or secondary diagnosis codes and utilized health care resource to receive prescriptions of COPD medication at least twice in 2009. Univariate logistic regression was performed to understand the relationship between COPD and GERD, and multiple logistic regression analysis was performed with adjustment for several confounding factors.

Results

The prevalence of GERD in COPD patients was 28% (39,987/141,057). Old age, female gender, medical aid insurance type, hospitalization, and emergency room (ER) visit were associated with GERD. Most of COPD medications except inhaled muscarinic antagonists were associated with GERD. The logistic regression analysis showed that the presence of GERD was associated with increased risk of hospitalization (OR 1.54, CI 1.50 to 1.58, p<0.001) and frequent ER visits (OR 1.55, CI 1.48 to 1.62, p<0.001).

Conclusions

The prevalence of GERD in patients with COPD was high. Old age, female gender, medical aid insurance type, and many COPD medications except inhaled muscarinic antagonists were associated with GERD. The presence of GERD was associated with COPD exacerbation.

Keywords:
Gastroesophageal reflux; Obstructive lung disease; Prevalence; Exacerbation; Anticholinergic