Your browser doesn't support javascript.
loading
Management and Risk of Mortality in Patients Hospitalised Due to a First Severe COPD Exacerbation.
Janson, Christer; Nwaru, Bright I; Wiklund, Fredrik; Telg, Gunilla; Ekström, Magnus.
Affiliation
  • Janson C; Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
  • Nwaru BI; Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
  • Wiklund F; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
  • Telg G; Statisticon AB, Uppsala, Sweden.
  • Ekström M; AstraZeneca Nordic-Baltic, Södertälje, Sweden.
Int J Chron Obstruct Pulmon Dis ; 15: 2673-2682, 2020.
Article de En | MEDLINE | ID: mdl-33149565
ABSTRACT

Background:

Reducing the need for hospitalisation in patients with chronic obstructive pulmonary disease (COPD) is an important goal in COPD management. The aim of this study was to evaluate re-hospitalisation, treatment, comorbidities and mortality in patients with COPD who were hospitalised for the first time due to a COPD exacerbation.

Methods:

This was a retrospective, population-based observational cohort study of Swedish patients using linked data from three mandatory national health registries to assess re-hospitalisation rates, medication use and mortality. Rate of hospitalisation was calculated using the number of events divided by the number of person-years at risk; risk of all-cause and COPD-related mortality were assessed using Cox proportional hazard models.

Results:

In total, 51,247 patients were identified over 10 years; 35% of patients were not using inhaled corticosteroid, long-acting muscarinic antagonist or long-acting ß2-agonist treatment prior to hospitalisation, 38% of whom continued without treatment after being discharged. Re-hospitalisation due to a second severe exacerbation occurred in 11.5%, 17.8% and 24% of the patients within 30, 90 and 365 days, respectively. Furthermore, 24% died during the first year following hospitalisation and risk of all-cause and COPD-related mortality increased with every subsequent re-hospitalisation. Comorbidities, including ischaemic heart disease, heart failure and pneumonia, were more common amongst patients who were re-hospitalised than those who were not.

Conclusion:

Following hospitalisation for first severe COPD exacerbation, many patients did not collect the treatment recommended by current guidelines. Risk of mortality increased with every subsequent re-hospitalisation. Patients with concurrent comorbidities had an increased risk of being re-hospitalised.
Sujet(s)
Mots clés

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Pneumopathie infectieuse / Broncho-pneumopathie chronique obstructive Type d'étude: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limites: Humans Langue: En Journal: Int J Chron Obstruct Pulmon Dis Année: 2020 Type de document: Article Pays d'affiliation: Suède

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Pneumopathie infectieuse / Broncho-pneumopathie chronique obstructive Type d'étude: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limites: Humans Langue: En Journal: Int J Chron Obstruct Pulmon Dis Année: 2020 Type de document: Article Pays d'affiliation: Suède