Overbeek Jetty A, Penning-van Beest Fernie J A, Balp Maria-Magdalena, Dekhuijzen P N Richard, Herings Ron M C
1PHARMO Institute , Utrecht , the Netherlands.
COPD. 2015 Apr;12(2):132-43. doi: 10.3109/15412555.2014.898053. Epub 2014 Jun 24.
The objective of this study was to compare rates of different types of acute exacerbations of COPD (AECOPDs) and healthcare utilization among patients with different severities of COPD.
Data for this study was obtained from the PHARMO Database Network, which includes drug dispensing records from pharmacies, hospitalization records and information from general practitioners. Patients with moderate to very severe COPD (GOLD II-III-IV) and a moderate or severe AECOPD between 2000 and 2010 were included in the study. Moderate and severe AECOPDs were defined by drug use and hospitalizations respectively. Study patients were followed from the first AECOPD to end of registration in PHARMO, death or end of study period, whichever occurred first. During follow-up, all recurrent AECOPDs were characterized and healthcare utilization was assessed.
Of 886 patients in the study, 52% had GOLD-II, 34% GOLD-III and 14% had GOLD-IV. The overall AECOPD recurrence rate per person year (PY) increased from 0.63 for patients with GOLD-II to 1.09 for patients with GOLD-III and 1.33 for patients with GOLD-IV. The rate of severe AECOPD was 0.06, 0.14 and 0.17 per PY, respectively.
AECOPD recurrence rates and healthcare utilization are significantly higher among patients with more severe COPD.
本研究的目的是比较慢性阻塞性肺疾病（COPD）不同严重程度患者中不同类型的慢性阻塞性肺疾病急性加重（AECOPD）发生率及医疗资源利用情况。
本研究数据来自PHARMO数据库网络，该网络包括药房的药品配药记录、住院记录以及全科医生提供的信息。纳入2000年至2010年间患有中度至非常严重COPD（慢性阻塞性肺疾病全球倡议[GOLD]分级II - III - IV级）且发生中度或重度AECOPD的患者。中度和重度AECOPD分别通过药物使用和住院情况进行定义。研究患者从首次发生AECOPD开始随访，直至在PHARMO数据库中注册结束、死亡或研究期结束，以先发生者为准。在随访期间，对所有复发性AECOPD进行特征描述，并评估医疗资源利用情况。
在该研究的886例患者中，52%为GOLD-II级，34%为GOLD-III级，14%为GOLD-IV级。人均年（PY）AECOPD总体复发率从GOLD-II级患者的0.63增加到GOLD-III级患者的1.09以及GOLD-IV级患者的1.33。重度AECOPD的发生率分别为每PY 0.06、0.14和0.17。
COPD病情越严重的患者，AECOPD复发率和医疗资源利用显著更高。
