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Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots an...

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Autores principales: Chan, Ta-Chien, Wang, Hsuan-Wen, Tseng, Tzu-Jung, Chiang, Po-Huang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690950/
https://www.ncbi.nlm.nih.gov/pubmed/26690457
http://dx.doi.org/10.3390/ijerph121215014
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author Chan, Ta-Chien
Wang, Hsuan-Wen
Tseng, Tzu-Jung
Chiang, Po-Huang
author_facet Chan, Ta-Chien
Wang, Hsuan-Wen
Tseng, Tzu-Jung
Chiang, Po-Huang
author_sort Chan, Ta-Chien
collection PubMed
description Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots and explore the possible risk factors for developing COPD. The first stage used the annual township COPD mortality from 2000 to 2012 and applied the retrospective space-time scan statistic to calculate the local relative risks in each township. In the second stage, we conducted a case-control study, recruiting 200 patients from one local hospital within the one identified hotspot area located in southern Taiwan. Logistic regression was applied for analyzing the personal risk factors of COPD. The univariate analyses showed that higher percentages of aborigines, patients with tuberculosis (TB) history, and those with smoking history had COPD (p < 0.05). After controlling for demographic variables, aboriginal status (adjusted odds ratios (AORs): 3.01, 95% CI: 1.52–5.93) and smoking history (AORs: 2.64, 95% CI: 1.46–4.76) were still the two significant risk factors. This two-stage approach might be beneficial to examine and cross-validate the findings from an aggregate to an individual scale, and can be easily extended to other chronic diseases.
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spelling pubmed-46909502016-01-06 Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD) Chan, Ta-Chien Wang, Hsuan-Wen Tseng, Tzu-Jung Chiang, Po-Huang Int J Environ Res Public Health Article Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots and explore the possible risk factors for developing COPD. The first stage used the annual township COPD mortality from 2000 to 2012 and applied the retrospective space-time scan statistic to calculate the local relative risks in each township. In the second stage, we conducted a case-control study, recruiting 200 patients from one local hospital within the one identified hotspot area located in southern Taiwan. Logistic regression was applied for analyzing the personal risk factors of COPD. The univariate analyses showed that higher percentages of aborigines, patients with tuberculosis (TB) history, and those with smoking history had COPD (p < 0.05). After controlling for demographic variables, aboriginal status (adjusted odds ratios (AORs): 3.01, 95% CI: 1.52–5.93) and smoking history (AORs: 2.64, 95% CI: 1.46–4.76) were still the two significant risk factors. This two-stage approach might be beneficial to examine and cross-validate the findings from an aggregate to an individual scale, and can be easily extended to other chronic diseases. MDPI 2015-12-10 2015-12 /pmc/articles/PMC4690950/ /pubmed/26690457 http://dx.doi.org/10.3390/ijerph121215014 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chan, Ta-Chien
Wang, Hsuan-Wen
Tseng, Tzu-Jung
Chiang, Po-Huang
Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title_full Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title_fullStr Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title_full_unstemmed Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title_short Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)
title_sort spatial clustering and local risk factors of chronic obstructive pulmonary disease (copd)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690950/
https://www.ncbi.nlm.nih.gov/pubmed/26690457
http://dx.doi.org/10.3390/ijerph121215014
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