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COPD In-Hospital Deaths Decreasing

Adherence is a major factor in outcomes for patients with chronic obstructive pulmonary disease.
Published Online: Jun 19,2017
Laurie Toich, Assistant Editor
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States and is a large contributor to healthcare costs. COPD can hinder an individual’s ability to breathe, which can subsequently lead to disability and diminished quality of life. More than 16 million Americans have been diagnosed with COPD, while millions more are unaware they have the condition.
 
Patients with COPD must remain adherent to costly and complex therapies to ensure their disease does not progress and they do not require hospitalization. The disease costs more than $32 billion per year, making it a growing public health concern, according to the National Institutes of Health.
 
A new study presented at the American Thoracic Society 2017 International Conference showed that in-hospital deaths decreased significantly between 2005 and 2014, despite a slight fluctuation in hospitalizations.
 
The authors gathered data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. This database includes information for 95% of all hospital discharges.
 
Between 2005 and 2014, the authors discovered there were 8,575,820 hospitalizations related to COPD. Also, during that time, in-hospital deaths decreased from 24,226 in 2005 to 9090 in 2014, which is a 62% reduction, according to the study.
 
Even when accounting for race, in-hospital deaths decreased among white, black, and Hispanic patients.
 
Interestingly, the authors noted that women with COPD accounted for a majority of hospitalizations and in-hospital deaths for the population. In total, women accounted for 57% to 58% of hospitalizations and 51% to 55% of in-hospital deaths for patients with COPD, according to the study.
 
"Other studies suggest possible explanations for the higher COPD burden women in the US have, including the growing number of women who smoke, the increased severity of symptoms they may experience, and longer life expectancy," said lead study author Khushboo Goel, MD.
 
During this time, the authors also found that the average age of patients hospitalized for COPD was consistently at age 67.
 
The investigators observed that the number of patients with COPD treated at teaching hospitals increased from 212,346 in 2005 to 371,215 in 2014, according to the study. Additionally, hospital stays decreased from 5.2 days to 4.2 days for these patients.
 
"This is certainly an encouraging trend," Dr Goel said. "We expected to see a decline because of improvements in caring for conditions such as pneumonia, sepsis, septic shock and thromboembolic diseases associated with COPD exacerbations, but the magnitude of the decline in mortality was surprising."