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2016年至2020年西班牙慢性阻塞性肺疾病(COPD)患者肺移植住院的临床特征和医院结局的时间趋势——COVID-19大流行的影响

Time Trends in Clinical Characteristics and Hospital Outcomes of Hospitalizations for Lung Transplantation in COPD Patients in Spain from 2016 to 2020-Impact of the COVID-19 Pandemic.

作者信息

De Miguel-Diez Javier, Jimenez-Garcia Rodrigo, Hernández-Barrera Valentin, Carabantes-Alarcon David, Zamorano-Leon Jose J, Cuadrado-Corrales Natividad, Omaña-Palanco Ricardo, González-Barcala Francisco Javier, Lopez-de-Andres Ana

机构信息

Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain.

Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.

出版信息

J Clin Med. 2023 Jan 26;12(3):963. doi: 10.3390/jcm12030963.

Abstract

(1) Background: To examine the clinical characteristics and hospital outcomes of hospitalization for lung transplantation in COPD patients in Spain from 2016 to 2020; and to assess if the COVID-19 pandemic has affected the number or the outcomes of lung transplantations in these patients. (2) Methods: We used the Spanish National Hospital Discharge Database to select subjects who had a code for COPD (ICD-10: J44) and had undergone a lung transplantation (ICD-10 codes OBYxxxx). (3) Results: During the study period, 704 lung transplants were performed among COPD patients (single 31.68%, bilateral 68.32%). The absolute number of transplants increased with raising rates of 8%, 14% and 19% annually from 2016 to 2019. However, a marked decrease of -18% was observed from 2019 to year 2020. Overall, 47.44% of the patients suffered at least one complication, being the most frequent lung transplant rejection (24.15%), followed by lung transplant infection (13.35%). The median length of hospital stay (LOHS) was 33 days and the in-hospital-mortality (IHM) was 9.94%. Variables associated with increased risk of mortality were a Comorbidity Charlson Index ≥ 1 (OR 1.82; 95%CI 1.08-3.05) and suffering any complication of the lung transplantation (OR 2.14; 95%CI 1.27-3.6). COPD patients in 2020 had a CCI ≥ 1 in a lower proportion than 2019 patients (29.37 vs. 38.51%; = 0.015) and less frequently suffered any complications after the lung transplantation (41.26 vs. 54.6%; = 0.013), no changes in the LOHS or the IHM were detected from 2019 to 2020. (4) Conclusions: Our study showed a constant increase in the number of lung transplantations from 2016 to 2019 in COPD patients, with a drop from 2019 to 2020, probably related to the COVID-19 pandemic. However, no changes in LOHS or IHM were detected over time.

摘要

(1) 背景:研究2016年至2020年西班牙慢性阻塞性肺疾病(COPD)患者肺移植住院的临床特征和医院结局;并评估2019冠状病毒病(COVID-19)大流行是否影响了这些患者的肺移植数量或结局。(2) 方法:我们使用西班牙国家医院出院数据库来选择患有COPD编码(国际疾病分类第十版:J44)且接受过肺移植(国际疾病分类第十版编码OBYxxxx)的受试者。(3) 结果:在研究期间,COPD患者共进行了704例肺移植(单肺移植31.68%,双肺移植68.32%)。从2016年到2019年,移植的绝对数量以每年8%、14%和19%的速度递增。然而,2019年至2020年观察到显著下降,降幅为18%。总体而言,47.44%的患者至少出现一种并发症,最常见的是肺移植排斥反应(24.15%),其次是肺移植感染(13.35%)。中位住院时间为33天,住院死亡率为9.94%。与死亡风险增加相关的变量包括合并症查尔森指数≥1(比值比1.82;95%置信区间1.08 - 3.05)以及出现任何肺移植并发症(比值比2.14;95%置信区间1.27 - 3.6)。2020年的COPD患者合并症查尔森指数≥1的比例低于2019年患者(29.37%对38.51%;P = 0.015),肺移植后出现任何并发症的频率也较低(41.26%对54.6%;P = 0.013),2019年至2020年未发现中位住院时间或住院死亡率有变化。(4) 结论:我们的研究表明,2016年至2019年COPD患者的肺移植数量持续增加,2019年至2020年有所下降,这可能与COVID-19大流行有关。然而,随着时间推移,未发现中位住院时间或住院死亡率有变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0248/9917456/ade28ca3d543/jcm-12-00963-g001.jpg

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