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. 2015 Oct 22:10:2285-94.
doi: 10.2147/COPD.S92614. eCollection 2015.

Time trends in coronary revascularization procedures among people with COPD: analysis of the Spanish national hospital discharge data (2001-2011)

Javier de Miguel-Díez  1 , Rodrigo Jiménez-García  2 , Valentín Hernández-Barrera  2 , Pilar Carrasco-Garrido  2 , Héctor Bueno  3 , Luis Puente-Maestu  1 , Isabel Jimenez-Trujillo  2 , Alejandro Alvaro-Meca  2 , Jesús Esteban-Hernandez  2 , Ana López de Andrés  2
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Time trends in coronary revascularization procedures among people with COPD: analysis of the Spanish national hospital discharge data (2001-2011)

Javier de Miguel-Díez et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: People with COPD suffering from coronary artery disease are frequently treated with revascularization procedures. We aim to compare trends in the use and outcomes of these procedures in COPD and non-COPD patients in Spain between 2001 and 2011.

Methods: We identified all patients who had undergone percutaneous coronary interventions (PCIs) and coronary artery bypass graft (CABG) surgeries, using national hospital discharge data. Discharges were grouped into: COPD and no COPD.

Results: From 2001 to 2011, 428,516 PCIs and 79,619 CABGs were performed. The sex and age-adjusted use of PCI increased by 21.27% per year from 2001 to 2004 and by 5.47% per year from 2004 to 2011 in patients with COPD. In-hospital mortality (IHM) among patients with COPD who underwent a PCI increased significantly from 2001 to 2011 (odds ratio 1.11; 95% confidence interval 1.03-1.20). Among patients with COPD who underwent a CABG, the sex and age-adjusted CABG incidence rate increased by 9.77% per year from 2001 to 2003, and then decreased by 3.15% through 2011. The probability of dying during hospitalization in patients who underwent a CABG did not change significantly in patients with and without COPD (odds ratio, 1.06; 95% confidence interval 0.96-1.17).

Conclusion: The annual percent change in PCI procedures increased in COPD and non-COPD patients. We found a decrease in the use of CABG procedures in both groups. IHM was higher in patients with COPD who underwent a PCI than in those without COPD. However, COPD did not increase the probability of dying during hospitalization in patients who underwent a CABG.

Keywords: COPD; coronary artery bypass graft surgery; hospitalization; in-hospital mortality; length of stay; percutaneous coronary intervention.

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Figures

Figure 1
Figure 1
Joinpoint analyses. Notes: Joinpoint analysis in annual PCI in patients with (A) and without (B) COPD in Spain, from 2001 to 2011. Joinpoint analysis in annual CABG in patients with (C) and without (D) COPD in Spain, from 2001 to 2011. Annual percent change (APC) (based on rates that were sex and age-adjusted using the Spanish National Statistics Institute Census projections) calculated by using joinpoint regression analysis. APC is significantly different from zero (two-sided P<0.05). Abbreviation: PCI, percutaneous coronary intervention.
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