Prognostic factors after hospitalization for COPD exacerbation

Abstract

Introduction: Hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are increasing in France. AECOPD are associated with impaired health status and increased health care costs.

Methods: Using data from the French national health insurance information system, we studied mortality, readmissions and lung function testing after discharge among adults hospitalized for AECOPD in 2013.

Results: The cumulative probabilities of death and readmission for EACOPD were 21% and 31% respectively. The survival was better among women, even after taking into account the other risk factors (age, previous hospitalization for AECOPD, comorbidities, exacerbation severity). In multivariate analysis, the risk of readmission was increased among men and people living in socially disadvantaged areas. A lung function testing was performed in 34% within 3 months after discharge. Female gender, advanced age, comorbidities and living in a disadvantaged area were associated with a lower frequency of lung function testing.

Conclusions: Women had a better prognosis than men after AECOPD hospitalization. The frequency of lung function testing after discharge remained low, particularly among women and people living in disadvantaged areas.

Keywords: Bronchopneumopathie chronique obstructive; Chronic obstructive pulmonary disease; Facteurs socio-économiques; Hospital readmissions; Hospitalisation; Hospitalization; Mortality; Mortalité; Réadmissions hospitalières; Socioeconomic factors.