Abstract:
Introduction. Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide, often associated
with multiple comorbidities that may complicate its clinical course. These comorbidities can exacerbate respiratory
symptoms, impair lung function, alter imaging findings, and significantly affect prognosis.
Material and methods. This analytical, observational, cross-sectional study included 80 patients with confirmed chronic
obstructive pulmonary disease, divided into two equal subgroups according to spirometric severity: GOLD 1-2 (n = 40)
and GOLD 3-4 (n = 40). Clinical, functional, and radiological parameters were evaluated. Comorbidity burden was assessed
using validated composite indices: Charlson Comorbidity Index, COTE, COPDCoRi, CODEX, and COMCOLD. Associations
between comorbidity scores, pulmonary function, high-resolution computed tomography findings, and clinical outcomes
were analyzed using SPSS v22.0. A p-value < 0.05 was considered statistically significant.
Results. The presence of comorbidities was high across all domains, with only minor differences between spirometric
stages. Structural abnormalities (emphysema, bronchiectasis, pulmonary hypertension) were more prevalent in GOLD 3-4
patients. A strong correlation was observed between composite indices and parameters such as forced expiratory volume
in 1 second, dyspnea, exacerbation rate, radiological findings, and GOLD stages. Logistic regression models showed that
the combination of COPD-specific indices (COTE, CODEX, COPDCoRi) significantly outperformed the Charlson index in
predicting severe COPD (AUC 0.86 vs. 0.63). High-resolution computed tomography findings variables also demonstrated
strong predictive value (AUC 0.81).
Conclusions. Comorbidities play a central role in shaping chronic obstructive pulmonary disease severity and prognosis.
The integration of composite comorbidity indices and imaging biomarkers enhances multidimensional patient stratification,
aligning with GOLD 2024 recommendations for personalized care.
