Management and risk of mortality in patients hospitalised due to a first severe COPD exacerbation
Janson, Christer ; Nwaru, Bright I. ; Wiklund, Fredrik ; Telg, Gunilla and Ekström, Magnus LU
(2020)
In International Journal of COPD
15.
p.2673-2682
- 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... (More)
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 β2-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.
(Less)
- author
- Janson, Christer
; Nwaru, Bright I.
; Wiklund, Fredrik
; Telg, Gunilla
and Ekström, Magnus
LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- COPD, Management, Mortality, Re-hospitalisation
- in
- International Journal of COPD
- volume
- 15
- pages
- 10 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:33149565
- scopus:85095423029
- ISSN
- 1176-9106
- DOI
- 10.2147/COPD.S276819
- language
- English
- LU publication?
- yes
- id
- 898f100f-08ea-45fa-b56a-e4fd5ff6f4e1
- date added to LUP
- 2020-11-23 10:00:26
- date last changed
- 2024-04-03 18:12:13
@article{898f100f-08ea-45fa-b56a-e4fd5ff6f4e1,
abstract = {{<p>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 β2-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.</p>}},
author = {{Janson, Christer and Nwaru, Bright I. and Wiklund, Fredrik and Telg, Gunilla and Ekström, Magnus}},
issn = {{1176-9106}},
keywords = {{COPD; Management; Mortality; Re-hospitalisation}},
language = {{eng}},
pages = {{2673--2682}},
publisher = {{Dove Medical Press Ltd.}},
series = {{International Journal of COPD}},
title = {{Management and risk of mortality in patients hospitalised due to a first severe COPD exacerbation}},
url = {{http://dx.doi.org/10.2147/COPD.S276819}},
doi = {{10.2147/COPD.S276819}},
volume = {{15}},
year = {{2020}},
}