Respiratory Diseases Unit, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2017 Aug;21(16):3680-3689.
A retrospective cohort study was performed, using administrative database of the Local Health Unit Roma-A (LHU RM-A). The included subjects were residing in one of the four districts and were hospitalized for COPD exacerbation in healthcare facilities of the LHU during years 2010-2012.
The aim of the present study is to evaluate the impact of comorbidities, length and costs of hospital stay in patients with COPD exacerbations. Chronic obstructive pulmonary disease (COPD) is often associated with other diseases (cardiovascular diseases, diabetes, metabolic syndrome, chronic renal failure, depression) that can increase risk of mortality and hospitalization.
A total of 1890 COPD patients are included in the study. The mean length of hospitalization is 12.25 days (SD ± 10.91), 11.63 days (SD ± 9.76) and 11.91 days (SD ± 9.69) with a mean cost of hospitalization amounting to euro 3683.48 (SD ± 2037.12), 3356.82 (SD ± 1674.86) and 3706.81 (SD ± 2087.72) in 2010, 2011 and 2012 respectively. The presence and number of comorbidities are positively and significantly associated to the length and cost of hospitalization. In particular, patients with cardiovascular diseases or diabetes mellitus associated with other comorbidities present the highest values of hospital stay and cost. The cost and the length of hospitalization were significantly linked to the number of comorbidities.
Comorbidities play an important role in the hospital management of COPD exacerbation, increasing health care costs related to this disease.
本研究采用罗马阿地区卫生局（LHU RM-A）的行政数据库进行回顾性队列研究。纳入的研究对象居住在四个区中的一个区，并且在 2010 年至 2012 年期间在 LHU 的医疗保健设施中因 COPD 加重住院。
本研究旨在评估 COPD 加重患者的合并症、住院时间和住院费用的影响。慢性阻塞性肺疾病（COPD）常与其他疾病（心血管疾病、糖尿病、代谢综合征、慢性肾功能衰竭、抑郁症）相关，这些疾病会增加死亡率和住院风险。
本研究共纳入 1890 例 COPD 患者。住院时间的平均值为 12.25 天（SD ± 10.91），住院费用的平均值为 3683.48 欧元（SD ± 2037.12），2010 年、2011 年和 2012 年分别为 11.63 天（SD ± 9.76）和 11.91 天（SD ± 9.69），11.91 天（SD ± 9.69）和 3356.82 欧元（SD ± 1674.86）。合并症的存在和数量与住院时间和费用呈正相关。患有心血管疾病或糖尿病的患者以及其他合并症的患者，住院时间和费用最高。住院费用和住院时间与合并症的数量显著相关。
合并症在 COPD 加重的医院管理中起着重要作用，增加了与该疾病相关的医疗保健费用。
