COPD hospitalizations have risen by nearly 70% since 2002 in Canada
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Key takeaways:
- Hospitalization for COPD is more common in recent years in Canada.
- Following adjustment for population growth and aging, those aged 40 to 64 years and women had more COPD admissions in 2017 vs. 2002.
The crude rate of hospitalizations for COPD in Canada increased by nearly 70% in 2017 compared with 2002, according to results published in CMAJ.
“Our results indicate that there is a persistent gap in outpatient care to prevent COPD exacerbations before they occur,” Kate M. Johnson, PhD, assistant professor in the faculty of medicine and faculty of pharmaceutical sciences at the University of British Columbia, told Healio. “Strategies for improving outpatient care for COPD are urgently needed to avoid overburdening our already strained hospitals.”
Johnson and colleagues assessed 1,134,359 hospital admissions for COPD of adults aged 40 years and older (average age, 74 years) in Canada to evaluate changes in annual rates from 2002 to 2017 and how these rates differed based on sex and age using spline regression.
To evaluate age, researchers created a younger cohort including those aged 40 to 64 years (21.2%; 53% women) and an older cohort including those aged 65 years or older (50.9% men).
Notably, the total number of admissions in 2017 was 89,384, demonstrating a 68.8% increase compared with the 52,937 admissions in 2002, according to researchers.
The rise in COPD hospitalizations from 2002 to 2017 was also portrayed through crude admission rates per 100,000 people (368 vs. 479), which persisted following adjustment for population growth, age and sex (437 vs. 479).
“We were surprised at the dramatic change in COPD admissions from 2002 to 2017, which increased by 9.6% after adjusting for demographic trends in population growth and aging,” Johnson told Healio. “This trend is particularly in contrast to all-cause admissions, which declined by 23% over the study period. It suggests there is an increasing gap in care for COPD compared to other conditions.”
Divided by age, both men and women in the younger cohort of individuals had heightened COPD admission rates from 2002 to 2017. Comparing the two sexes, younger men demonstrated a larger increase in this timeframe than younger women (men, 119 to 148 per 100,000 people vs. women, 139 to 156 per 100,000 people).
Among those belonging to the older age group, women had a 29.8% rise in age-standardized rates, whereas men in this group had a 9% reduction (1,341 vs. 1,220 per 100,000), according to researchers.
In an age subgroup analysis, researchers found that those aged 40 to 54 years had the greatest increase in the average relative change of the sex- and age-standardized COPD hospitalization rate at 2.4% per year (95% CI, 1.7%-3.1%), whereas those aged 65 to 74 years had the greatest reduction in this annual relative change (–0.9%; 95% CI, –1.3% to –0.5%).
In terms of readmissions, the adjusted rate in 2017 was 15.4% higher than the rate in 2002 (209 per 100,000 people vs. 181 per 100,000 people).
Despite the heightened rate of COPD admissions and readmissions that occurred over 16 years, both in-hospital mortality and hospitalization duration went down for these patients regardless of age or sex.
Lastly, researchers found that five out of the eight most frequent comorbidities of this patient population with COPD occurred more often in 2017 than 2002, including acute kidney failure; bronchopneumonia; pneumonia; other lung diseases; and fluid-, electrolyte- and acid-based disorders.
“Future studies should examine factors driving these trends,” Johnson told Healio. “Possible explanations for increasing COPD hospitalizations are that COPD patients are living longer and developing more comorbidities leading to more repeat admissions. It’s also possible that patients are being discharged prematurely and returning to hospital more quickly.”
Reference:
- Hospital admissions for COPD increased substantially, especially in women and younger people. https://pharmsci.ubc.ca/news/september-09-2023/hospital-admissions-copd-increased-substantially-especially-women-and. Published Sept. 12, 2023. Accessed Sept. 12, 2023.