Association Between Chronic Obstructive Pulmonary Disease and Gastroesophageal Reflux Disease

A National Cross-sectional Cohort Study

Jinhee Kim; Jin Hwa Lee; Yuri Kim; Kyungjoo Kim; Yeon-Mok Oh; Kwang Ha Yoo; Chin Kook Rhee; Hyoung Kyu Yoon; Young Sam Kim; Yong Bum Park; Sei Won Lee; Sang Do Lee


BMC Pulm Med. 2013;13(51) 

In This Article


The prevalence of GERD in patients with COPD was 28% (39,987/141,057).

General characteristics of patients with COPD according to the presence or absence of GERD were summarized in Table 1. COPD patients with GERD had more hospitalization and ER visits than those without GERD (all p < 0.001), whereas there was no difference of ICU hospitalization between two groups. More patients with COPD and GERD used medical services for treatment of all kinds of comorbidity than did those without GERD (all p < 0.001; Table 1).

Medication used for both group was summarized in Table 2.

A regression model including general characteristics indicated that more female than male patients with COPD had GERD and more patients in their 50s, 60s, and 70s had GERD compared with those in their 40s. More GERD was observed in the medical aid group compared with the health insurance group, and in subjects with hospitalization experience compared with subjects without hospitalization. Less GERD was observed in subjects with ICU hospitalization than in those without. More GERD were observed in subjects with ER visits compared with those without (Table 3).

After adjusting for sex, age, type of health insurance, hospitalization, ICU hospitalization, category of ER visit, and COPD severity, more patients with COPD and GERD had comorbidities except congestive heart failure. More GERD was observed among patients using ICSs, ICSs/LABAs, LTRAs, OCSs, oral beta-2 agonists, and theophylline (all p < 0.001). However, less GERD was observed in association with SAMAs use [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93 to 0.99; Table 4].

After adjusting for sex, age, type of health insurance, and COPD severity, the regression model demonstrated that COPD exacerbation was more prevalent among patients with GERD than among those without GERD, as indicated by more hospitalization (OR 1.54, 95% CI 1.50 to 1.58) and ER visits (OR 1.55, 95% CI 1.48 to 1.62; Table 5).