Trends and hospital outcomes of lung transplantation among patients with and without chronic obstructive pulmonary disease in Spain: a national population-based study (2001–2015)

Abstract

Purpose

To describe trends from 2001 to 2015 in incidence and in-hospital outcomes of patients suffering or not suffering from COPD who had undergone lung transplantation (LTx) in Spain.

Methods

We used the Spanish National Hospital Discharge Database to select all admissions for LTx. Incidence was estimated overall and according to the presence of COPD. Outcomes included infections, complications, length of hospital stay and in-hospital mortality (IHM).

Results

We identified 2,896 admissions for LTx. Admission rates rose in COPD sufferers and non-COPD sufferers over time, with higher rates among COPD patients. COPD and non-COPD patients were older, but mean age was higher in COPD patients. Although there was a male predominance among patients, the proportion of women significantly increased over time in the COPD population. COPD patients had lower Charlson Comorbidity Index values than non-COPD patients (score ≥1, 25.83% and 31.6%, P<0.05). We observed a significant increase in infections and complications of LTx or rejection for both groups over time. IHM decreased from 2001 to 2015 in both groups of patients. COPD was a predictor of lower IHM (OR 0.75, 95% CI 0.61–0.93) after LTx.

Conclusion

LTx-incidence rates were higher in COPD patients and increased over the study period in both groups. The proportion of women significantly increased over time among COPD sufferers. IHM decreased from 2001 to 2015 in both groups of patients. COPD was a predictor of lower mortality during admissions for LTx.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2019

Publication date (Electronic): 27 March 2019

Volume: 14

Pages: 729-737

Affiliations

[1 ]Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain

[2 ]Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain, ana.lopez@ 123456urjc.es

[3 ]Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain

[4 ]Internal Medicine Department, Hospital Universitario Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain

Author notes

Correspondence: Ana López-de-Andres, Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas, Alcorcón, Madrid 28922, Spain, Email ana.lopez@ 123456urjc.es

Article

Publisher ID: copd-14-729

DOI: 10.2147/COPD.S189010

PMC ID: 6443219

Copyright statement: © 2019 de Miguel-Díez et al. This work is published and licensed by Dove Medical Press Limited

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Categories

Subject: Original Research