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