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      Long-Term Trends in Hospitalization and Outcomes in Adult Patients with Exacerbation of Chronic Obstructive Pulmonary Disease in Beijing, China, from 2008 to 2017

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          Abstract

          Background and Objective

          Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. We aimed to evaluate the temporal trends in hospitalization and mortality from acute exacerbation of COPD (AECOPD) and the associated financial costs over a 10-year period in Beijing, China.

          Methods

          Hospital admission records from 2008 to 2017 for all patients aged ≥20 years with a primary discharge diagnosis of AECOPD were retrieved from the Beijing Public Health Information Center Database. Joinpoint regression was used to analyze trends and calculate the annual percentage change (APC) and average annual percent change (AAPC) for AECOPD hospitalization and mortality.

          Results

          A total of 337,802 AECOPD cases were recorded from 2008 to 2017. An inverse U-shaped trend in the AECOPD hospitalization rate was observed, showing an increase from 150.2 per 100,000 inhabitants in 2008 to 218.7 per 100,000 inhabitants in 2014 (APC: 5.5%, 95% CI: 2.9–8.2), before declining to 161.13 per 100,000 inhabitants in 2017 (APC: −9.7%, 95% CI: −16.0 to-2.9). In-hospital mortality from AECOPD decreased significantly from 3.91% to 2.21% (AAPC: −11.4%, 95% CI: −15.5 to−7.0). A decline in the median length of hospital stay from 13.0 days in 2008 to 12.0 days in 2017 ( P trend < 0.001) was accompanied by a decrease in the use of mechanical ventilation from 2012 to 2017 ( P trend < 0.001). However, the total hospitalization cost per case increased from 15953.5 yuan (USD $2281.4) to 19874.5 yuan ($2842.1) during the same period.

          Conclusion

          AECOPD remains a heavy burden on the health care system in Beijing. Strategies to better manage COPD and reduce hospitalizations from AECOPD are needed.

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          Most cited references 17

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          Health impact of China's Air Pollution Prevention and Control Action Plan: an analysis of national air quality monitoring and mortality data

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            Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease.

            Small clinical trials have shown that noninvasive ventilation (NIV) is efficacious in reducing the need for intubation and improving short-term survival among patients with severe exacerbations of chronic obstructive pulmonary disease (COPD). Little is known, however, about the effectiveness of NIV in routine clinical practice.
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              Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010.

              We aim to analyze changes in incidence, comorbidity profile, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) of patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) over a 5-year study period in Spain.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                COPD
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                21 May 2020
                2020
                : 15
                : 1155-1164
                Affiliations
                [1 ]Department of Clinical Epidemiology and Tobacco Dependence Treatment Research, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University , Beijing, People’s Republic of China
                [2 ]Department of Epidemiology and Biostatistics, University of Georgia College of Public Health , Athens, GA, USA
                [3 ]Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University , Beijing, People’s Republic of China
                Author notes
                Correspondence: Zhaohui Tong Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University , No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing100020, People’s Republic of ChinaTel +86-10-85231610Fax +86-10-65060167 Email tongzhaohuicy@sina.com
                Article
                238006
                10.2147/COPD.S238006
                7247605
                32547003
                © 2020 Liang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, Tables: 4, References: 31, Pages: 10
                Categories
                Original Research

                Respiratory medicine

                copd, exacerbation, hospitalization cost, mortality, outcome research

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