Real-life burden of hospitalizations due to COPD exacerbations in Spain

Abstract

Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation of symptoms (ECOPD) that may eventually require hospitalization due to several, often overlapping, causes. We aimed to analyse the characteristics of patients hospitalized because of ECOPD in a real-life setting using a big-data approach. The study population included all patients older than 40 years with a diagnosis of COPD (n=69.359; prevalence 3.72%) registered since January 1st, 2011, until March 1, 2020, in the database of the public healthcare service (SESCAM) of Castilla-La Mancha (Spain) (n=1.863.759 subjects). We used natural language processing (Savana Manager v3.0) to identify those who were hospitalized during this period for any cause, including ECOPD. During the study 26.453 COPD patients (38.1%) were hospitalized (at least once). Main diagnoses at discharge were respiratory infection (51%), heart failure (38%) or pneumonia (19%). ECOPD was the main diagnosis at discharge (or hospital death) in 8.331 of them (12.0% of the entire COPD population and 31.5% of those hospitalized). In-hospital ECOPD-related mortality rate was 3.1%. These patients were hospitalized 2.36 times per patient, with a mean hospital stay of 6.1 days. Heart failure (HF) was the most frequent comorbidity in patients hospitalized because of ECOPD (52.6%). This analysis shows that, in a real-life setting, ECOPD hospitalizations are prevalent, complex (particularly in relation to HF), repetitive and associated with significant in-hospital mortality.