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Increasing costs, mortality rates related to admissions for COPD exacerbations

In France, researchers associated rising incidence of severe COPD exacerbations with increasing intensive care unit admissions, according to recent study results.

“Strategies aimed at improving the treatment and prevention of exacerbations remain far from being fully effective… [however,] in recent years the quality control of registries dramatically improved in France,” Nicolas Molinari, MCU-PH, from the University of Montpellier, and colleagues wrote. “We aimed to understand whether features of COPD hospitalizations are changing in France with regard to incidence, severity, management, outcomes, and costs.”

The researchers examined medico-administrative database records of severe exacerbations of COPD leading to hospitalizations in France from 2007 to 2012. They defined four groups of severe COPD exacerbations: hospitalization in a general ward without acute respiratory failure, general ward with acute respiratory failure, ICU without invasive mechanical ventilation, and ICU with mechanical ventilation.

Molinari and associates found admissions increased from 113,276 to 133,497 (15.48% increase) over the six-year period. The number of ICU admissions grew by 41.78% while age, gender, and length of stay changed only slightly. The investigators observed in-hospital mortality rates rose by 8.06% (P < .001), with pneumonia-related mortality increasing by 37.2%. Total hospitalization costs rose from 602 to 678 million euros (12.6% increase).

“The underlying motivation was to identify areas of improvement,” Molinari and colleagues wrote. “The trends reported here (notably the increasing incidence, costs and mortality of severe COPD exacerbations) represent a major warning for institutions, physicians and patients and should lead to extensively [rethinking] COPD management plans and allocation of dedicated health care resources in France.” – by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.