Association between anticoagulant therapy, exacerbations and mortality in a Danish cohort of patients with Chronic Obstructive Pulmonary Disease

OBJECTIVES

Pulmonary Embolism has been frequently reported in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD). The study aimed to determine whether COPD patients who receive anticoagulant (AC) therapy have a reduced risk of hospitalization due to AE-COPD and death.

METHODS

This nationwide population-based study was based on data from the Danish Register of COPD (DrCOPD), which contains complete data on COPD outpatients between 1st January 2010 and 31st December 2018. National registers were used to obtain information regarding comorbidities and vital status. Propensity-score matching and Cox proportional hazards models were used to assess AE-COPD and death after one year.

RESULTS

The study cohort consisted of 58,067 patients with COPD. Of these, 5194 patients were on AC therapy. The population was matched 1:1 based on clinical confounders and AC therapy, resulting in two groups of 5180 patients. We found no association between AC therapy and AE-COPD or all-cause mortality in the propensity-score matched population (HR 1.03, 95% CI 0.96-1.10, p = 0.37). These findings were confirmed in a competing risk analysis. In the sensitivity analysis, we performed an adjusted analysis of the complete cohort and found a slightly increased risk of AE-COPD or death in patients treated with AC therapy. This study found a low incidence of pulmonary embolisms and deep venous thrombosis in both groups.

CONCLUSIONS

AC therapy was not associated with the risk of hospitalization due to AE-COPD or all-cause mortality.

Home aids and personal assistance 10-45 years after spinal cord injury

OBJECTIVE

Assessment of home aids, adaptations and personal assistance received after traumatic spinal cord injury (SCI).

SETTING

Clinic for Spinal Cord Injuries, Denmark. Uptake area, 2.5 million inhabitants.

STUDY DESIGN AND METHODS

Cross-sectional follow-up with retrospective data from medical files.

MATERIALS

Individuals with traumatic SCI before 1 January 1991, still in regular follow-up and with sufficient medical record. In all, 279 were included, and 236 answered the questionnaire (193 men and 43 women), with a response rate of 84.6%. Mean age at follow-up was 50.5 years, and mean follow-up time, 24.1 years. One hundred and twenty-six were paraplegic and 110, tetraplegic. Responders and non-responders were comparable.

RESULTS

Most common aids or adaptations reported were commode/shower chair on wheels or a seat (69%), grab bar by the toilet (41%), electrical bed (44%), special mattress (28%), lift/hoist (20%), computers (39%) and kitchen tools or cutlery with special handles (14%). In all, 7.6% of the participants reported no aids. Eighty-two percent answered 'Yes' to the question 'Have the aids, you currently or previously needed, been available to you?' The majority reported that their source of information about aid had been various journals and magazines. Twenty-one percent had personal helpers, with 60 h per week in median (range 2-168). Thirty-three percent received domestic help with 2.5 h per week in median (range 0.5-37). Eight percent had a home nurse. A total of 98.7% were living in their own homes.

CONCLUSIONS

This is the first study of a representative SCI population giving information on home aids. Individuals with SCI in Denmark seem to be sufficiently supplied with aids and personal assistance.