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Mortality after first hospitalization for chronic obstructive pulmonary disease: changes in 1980-1998
O Säynäjäkangas1, P Lampela, M Koiranen
1Lapland Central Hospital, Department of Pulmonary Diseases, Rovaniemi, Finland.
Central European Journal of Public Health
|April 8, 2004
Summary
The prognosis for hospitalized patients with chronic obstructive pulmonary disease (COPD) worsened significantly over ten years, particularly for younger individuals. This trend may be linked to changes in care and increased smoking rates in women.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Health Services Research
Background:
- Hospitalized patients with chronic obstructive pulmonary disease (COPD) have a historically poor prognosis.
- Understanding trends in COPD prognosis is crucial for public health and clinical management.
Purpose of the Study:
- To investigate changes in the prognosis of first-time hospitalized COPD patients over a ten-year period.
- To identify demographic differences in COPD prognosis trends.
Main Methods:
- Retrospective cohort study using Finnish national hospital discharge and mortality records (1972-1998).
- Analysis of two groups: first hospitalization for COPD in 1980-1984 versus 1990-1994.
- Cox regression analysis, age-standardized, to compare mortality rates and hazard ratios.
Main Results:
- Overall mortality increased significantly for both men and women hospitalized for COPD between the two periods.
- The prognosis worsened most notably in the 45-64 age group, with higher hazard ratios for both sexes.
- Women, especially younger women, experienced a more pronounced deterioration in prognosis compared to men.
Conclusions:
- The prognosis for first-time hospitalized COPD patients has deteriorated over a decade.
- Factors contributing to this decline may include shifts in outpatient care, reduced rehabilitation, and increased smoking prevalence in women.
- Targeted interventions are needed to address the worsening prognosis of COPD.