Izquierdo José Luis, Rodríguez José Miguel, Almonacid Carlos, Benavent María, Arroyo-Espliguero Ramón, Agustí Alvar
Dept of Medicine and Medical Specialties, University of Alcalá, Alcalá de Henares, Spain.
Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spain.
ERJ Open Res. 2022 Aug 15;8(3). doi: 10.1183/23120541.00141-2022. eCollection 2022 Jul.
Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation of symptoms (ECOPD) that may eventually require hospitalisation due to several, often overlapping, causes. We aimed to analyse the characteristics of patients hospitalised because of ECOPD in a real-life setting using a "big data" approach.
The study population included all patients over 40 years old with a diagnosis of COPD (n=69 359; prevalence 3.72%) registered from 1 January 2011 to 1 March 2020 in the database of the public healthcare service (SESCAM) of Castilla-La Mancha (Spain) (n=1 863 759 subjects). We used natural language processing (Savana Manager version 3.0) to identify those who were hospitalised during this period for any cause, including ECOPD.
During the study 26 453 COPD patients (38.1%) were hospitalised (at least once). Main diagnoses at discharge were respiratory infection (51%), heart failure (38%) or pneumonia (19%). ECOPD was the main diagnosis at discharge (or hospital death) in 8331 patients (12.0% of the entire COPD population and 31.5% of those hospitalised). In-hospital ECOPD-related mortality rate was 3.11%. These patients were hospitalised 2.36 times per patient, with a mean hospital stay of 6.1 days. Heart failure was the most frequent comorbidity in patients hospitalised because of ECOPD (52.6%).
This analysis shows that, in a real-life setting, ECOPD hospitalisations are prevalent, complex (particularly in relation to heart failure), repetitive and associated with significant in-hospital mortality.
慢性阻塞性肺疾病（COPD）患者经常出现症状加重发作（ECOPD），由于多种往往相互重叠的原因，最终可能需要住院治疗。我们旨在采用“大数据”方法分析在现实环境中因ECOPD住院的患者特征。
研究人群包括2011年1月1日至2020年3月1日在西班牙卡斯蒂利亚 - 拉曼恰公共医疗服务数据库（SESCAM）中登记的所有40岁以上诊断为COPD的患者（n = 69359；患病率3.72%）（n = 1863759名受试者）。我们使用自然语言处理（Savana Manager 3.0版）来识别在此期间因任何原因住院的患者，包括ECOPD。
在研究期间，26453名COPD患者（38.1%）至少住院一次。出院时的主要诊断为呼吸道感染（51%）、心力衰竭（38%）或肺炎（19%）。ECOPD是8331名患者出院时（或医院死亡时）的主要诊断（占整个COPD人群的12.0%，占住院患者的31.5%）。住院期间ECOPD相关死亡率为3.11%。这些患者每人住院2.36次，平均住院时间为6.1天。心力衰竭是因ECOPD住院患者中最常见的合并症（52.6%）。
该分析表明，在现实环境中，ECOPD住院很普遍、情况复杂（尤其是与心力衰竭相关）、具有重复性且与显著的住院死亡率相关。
