Yasuhiro Yamauchi1,2, Hideo Yasunaga3, Hiroki Matsui3, Wakae Hasegawa1, Taisuke Jo1,2, Kazutaka Takami1, Kiyohide Fushimi4, Takahide Nagase1. 1. Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 2. Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan. 3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. 4. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND AND OBJECTIVE: Obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD), have airflow limitation associated with chronic inflammation. Using a national inpatient database in Japan, we aimed to evaluate factors affecting in-hospital mortality in patients with asthma, COPD or asthma-COPD overlap (ACO). METHODS: We retrospectively collected data for inpatients (age >40 years) with exacerbation of COPD and/or asthma in 1073 hospitals across Japan between July 2010 and May 2013. We performed multivariable logistic regression analysis to examine the association of various factors with all-cause in-hospital mortality, including diagnosis of ACO, asthma alone and COPD alone. RESULTS: Of 30 405 eligible patients, in-hospital mortality in patients with ACO, asthma alone and COPD alone was 2.3%, 1.2% and 9.7%, respectively. COPD patients had a significantly higher mortality than ACO patients (odds ratio 1.96; 95% confidence interval: 1.38-2.79); patients with asthma alone showed lower mortality (0.70; 0.50-0.97). Higher mortality was also significantly associated with older age, male gender, lower body mass index, more severe dyspnoea, lower level of consciousness, worse activities of daily life and higher daily dose of corticosteroids. CONCLUSION: Asthma alone was associated with lower mortality, but COPD alone was associated with higher mortality than ACO.
BACKGROUND AND OBJECTIVE: Obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD), have airflow limitation associated with chronic inflammation. Using a national inpatient database in Japan, we aimed to evaluate factors affecting in-hospital mortality in patients with asthma, COPD or asthma-COPD overlap (ACO). METHODS: We retrospectively collected data for inpatients (age >40 years) with exacerbation of COPD and/or asthma in 1073 hospitals across Japan between July 2010 and May 2013. We performed multivariable logistic regression analysis to examine the association of various factors with all-cause in-hospital mortality, including diagnosis of ACO, asthma alone and COPD alone. RESULTS: Of 30 405 eligible patients, in-hospital mortality in patients with ACO, asthma alone and COPD alone was 2.3%, 1.2% and 9.7%, respectively. COPDpatients had a significantly higher mortality than ACO patients (odds ratio 1.96; 95% confidence interval: 1.38-2.79); patients with asthma alone showed lower mortality (0.70; 0.50-0.97). Higher mortality was also significantly associated with older age, male gender, lower body mass index, more severe dyspnoea, lower level of consciousness, worse activities of daily life and higher daily dose of corticosteroids. CONCLUSION:Asthma alone was associated with lower mortality, but COPD alone was associated with higher mortality than ACO.
Authors: Amy Todd; Samantha Blackley; Jennifer K Burton; David J Stott; E Wesley Ely; Zoë Tieges; Alasdair M J MacLullich; Susan D Shenkin Journal: BMC Geriatr Date: 2017-12-08 Impact factor: 3.921