Five-year all-cause hospitalizations in patients with COPD following their first-ever exacerbation-related hospitalization

Abstract

Hospital admissions are important contributors to the overall burden of chronic obstructive pulmonary disease (COPD). Understanding the patterns and causes of hospital admissions will help to identify targets for preventive interventions. This study aimed to determine the five-year all-cause hospital admission trajectories of patients with COPD following their first-ever exacerbation-related hospitalization. Patients with COPD were identified from the Danish national registries. The index event was defined as the first exacerbation-related hospitalization between 2000 and 2014. All-cause hospital admissions were examined during a subsequent five-year follow-up period, and categorized using the International Classification of Diseases, 10th revision (ICD-10). In total, 82964 patients with COPD were included. The average age was 72 (SD 10) years and 48% was male. Comorbidities were present in 58%, and 65% of the patients collected inhalation medication ≤6 months prior to the index event. In total, 337066 all-cause hospital admissions were identified, resulting in a five-year admission rate of 82%. Most admissions were due to non-respiratory causes (59%), amongst which cardiac events were most common (19%). Hospital admissions following a first exacerbation-related hospitalization are common, non-respiratory admissions constitute the majority of admissions. Treatment targeting both the respiratory, but especially the non-respiratory causes of hospital admission should be considered to effectively decrease the burden of hospitalization in COPD.