Hospitalizations due to exacerbations of COPD: A big data perspective
Por:
Serra-Picamal, X, Roman, R, Escarrabill, J, Garcia-Altes, A, Argimon, JM, Soler, N, Faner, R, Carbonell, EM, Trilla, A, Agusti, A
Publicada:
1 dic 2018
Resumen:
Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) may suffer episodes of exacerbation (ECOPD) that require hospitalization and worsen their health status, and prognosis. We hypothesized that a detailed interrogation of health-care "big data" databases can provide valuable information to better understand the risk factors and outcomes of these episodes.
Material and methods: We interrogated four databases of the Catalan health-care system (< 8,000,000 registries) to identify patients hospitalized because of ECOPD for the first time (index event) between 2010 and 2012. Analysis was carried forward since the index event until the end of 2014 or the death of the patient. The two years that preceded the index event were also investigated.
Results: We identified 17,555 patients, (>= 50 years of age) hospitalized because of ECOPD (ICD9 v.9 codes at discharge) for the first time between 2010 and 2012. In this population we observed that: (1) 23% of patients die within a year after being discharged from their first ECOPD hospitalization; (2) in the remaining patients, allcause mortality was related to the number of re-hospitalizations, particularly with early (< 30 days) readmissions; (3) despite this being a 'respiratory' cohort, prescription and dispensation of drugs for cardiovascular diseases was higher than for obstructive airway diseases; and, finally, (4) lower winter ambient temperatures are associated with hospital admissions for ECOPD particularly in early re-admitters.
Conclusions: Overall these results indicate under appreciation of the burden of COPD in patients hospitalized for the first time because ECOPD.
Filiaciones:
Serra-Picamal, X:
Agencia & Qualitat Avaluacio Sanit Catalunya AQuA, Barcelona, Spain
Roman, R:
Agencia & Qualitat Avaluacio Sanit Catalunya AQuA, Barcelona, Spain
Escarrabill, J:
Univ Barcelona, Hosp Clin, Barcelona, Spain
Govern Generalitat Catalunya, Dept Salut, Master Plan Resp Dis PDMAR, Barcelona, Spain
Inst Salud Carlos III, Chron Patients Network, Hlth Serv Res, REDISSEC, Madrid, Spain
Garcia-Altes, A:
Agencia & Qualitat Avaluacio Sanit Catalunya AQuA, Barcelona, Spain
Argimon, JM:
Govern Generalitat Catalunya, Dept Salut, Barcelona, Spain
Soler, N:
Univ Barcelona, Hosp Clin, Barcelona, Spain
Inst Invest Biomed August Pi Sunyer IDIBAPS, Barcelona, Spain
Inst Salud Carlos III, CIBER Enfermedades Respiratorias CIBERES, Madrid, Spain
Faner, R:
Inst Invest Biomed August Pi Sunyer IDIBAPS, Barcelona, Spain
Inst Salud Carlos III, CIBER Enfermedades Respiratorias CIBERES, Madrid, Spain
Carbonell, EM:
Agencia & Qualitat Avaluacio Sanit Catalunya AQuA, Barcelona, Spain
Trilla, A:
Agencia & Qualitat Avaluacio Sanit Catalunya AQuA, Barcelona, Spain
Univ Barcelona, Hosp Clin, Barcelona, Spain
Agusti, A:
Univ Barcelona, Hosp Clin, Barcelona, Spain
Inst Invest Biomed August Pi Sunyer IDIBAPS, Barcelona, Spain
Inst Salud Carlos III, CIBER Enfermedades Respiratorias CIBERES, Madrid, Spain
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