An elderly patient with bronchial asthma in real-time medical practice
Abstract. The relevance of this study is due to the lack of characteristic of elderly patients with bronchial asthma (BA) taking into account comorbidity in real-time medical practice.E.O. Baev, V.I. Kupaev, A.N. Popchenkov, A.N. Sanatina, E.E. Shlepnev
The aim: to characterize patients over 65 years of age with BA in a real-time clinical settings.
Material and methods. A multicenter, cross-sectional, retrospective cohort study was performed. It involved 565 patients with BA, who were divided into two age groups: Group 1 (main group) – patients over 65 years of age (n = 423), Group 2 (comparison group) – patients aged 45–65 years (n = 142). The analysis included a review of outpatient records, medical history, assessment of the Charlson Comorbidity Index, determination of asthma control, and a study of pharmacotherapy.
Results. The study revealed significant differences in the clinical course of BA across different age groups. Patients over 65 years of age were found to have higher comorbidity (Charlson index 4.09 ± 1.40 vs. 1.75 ± 1.49 in the 45–65 age group), later disease onset (age at diagnosis 57.95 ± 14.2 vs. 44.78 ± 11.35 years), and higher doses of inhaled glucocorticosteroids (598.29 vs. 494.91 mcg/day). Cluster analysis of 565 patients revealed significant characteristic peculiarities of elderly patients with BA.
Conclusion. The study demonstrates the need for a differentiated approach to the management of patients with bronchial asthma in different age groups. The identified differences in BA clinical course require special attention to elderly patients, taking into account the higher comorbidity and later disease diagnosis in this group.
Keywords
bronchial asthma
elderly patients
comorbidity
inhaled glucocorticosteroids
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About the Authors
Evgeny O. Baev, MD, 2nd-year resident of the Department of family medicine, I.I. Mechnikov North-Western State Medical University; general practitioner at Saint Petersburg City Polyclinic No. 78, Saint Petersburg, Russian Federation.E-mail: eobaev@yandex.ru
ORCID: https://orcid.org/0009-0004-0438-8310
Vitaly I. Kupaev, MD, Dr. Sci. (Medicine), professor, professor of the Department of family medicine, I.I. Mechnikov North-Western State Medical University. Saint Petersburg, Russian Federation.
E-mail: vk1964sam@rambler.ru
ORCID: https://orcid.org/0000-0003-2639-0003
Arseniy N. Popchenkov, 6th year student of the Institute of fundamental medicine, I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russian Federation.
E-mail: popchenkovarsenii619@gmail.com
ORCID: https://orcid.org/0009-0007-5806-0443
Anastasia N. Sanatina, MD, pulmonologist of the highest qualification category, Saint Petersburg City Polyclinic No. 78, Saint Petersburg, Russian Federation.
E-mail: sanatina.ana@mail.ru
ORCID: https://orcid.org/0009-0000-5407-5540
Evgeny E. Shlepnev, MD, head of Saint Petersburg City Polyclinic No. 78, Saint Petersburg, Russian Federation.
E-mail: esch78pol@mail.ru
ORCID: https://orcid.org/0009-0008-5658-6633
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