{"title":"2017 - 2022年慢性阻塞性肺病疾病负担：意大利阿普利亚地区44260例住院分析","authors":"Emanuela Resta, Giusi Graziano, Giacomo Riformato, Chiara Noviello, Silvio Tafuri, Paola Pierucci","doi":"10.1159/000542908","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Natural history of chronic obstructive pulmonary disease (COPD) is characterized by a progressive decline in pulmonary function and recurrent exacerbations, requiring frequent hospital admissions to medical wards. Great heterogeneity still exists between studies hindering our understanding of the true, global burden of AECOPD on healthcare systems over COVID-19 pandemic. We aimed to describe the AECOPD in the southern Italian region from 2017 to 2022 and to detail the location of admission, rate and characteristics of deaths, and use of noninvasive respiratory supports.</p><p><strong>Methods: </strong>Retrospective, cross-sectional study carried out in collaboration with the Apulian Regional Observatory for Epidemiology over the second semester of 2023. Selected records with specific ICD-9 codes related to AECOPD and its clinical details, related complications, number of re-hospitalization, and noninvasive respiratory support use described as \"principal\" or \"secondary\" or \"other diagnosis\" were considered.</p><p><strong>Results: </strong>From 2017 to 2022, a total of 29,917 patients with AECOPD were admitted to hospital, and they generated a total of 44,260 hospitalizations. The male gender represented 60.9% of the total, mean age 77.1 ± 11.2 years. Deaths were 3,743, complicated by other comorbidities in 54% of cases. Readmissions rate was 8.5%. Deaths allocation was as follows: intensive care 37.7%, general medicine 33%, respiratory ward 13.5%, etc. Noninvasive respiratory supports were used in 47% of cases.</p><p><strong>Conclusion: </strong>This prolonged and deeply characterized clinical observation of AECOPD admissions, including COVID-19 pandemic years, in Apulia region, shows that they present at older age, affected by one\\more comorbidities with more severe disease requiring in almost half a percentage of cases the use of respiratory support (HFNC and NIV). However, the high rate of deaths highlights the urgent need to further support the most severe cases who deserve more tailored ward allocation and care management.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic Obstructive Pulmonary Disease Burden of Disease from 2017 to 2022: Analysis of 44,260 Hospitalizations in the Italian Apulian Region.\",\"authors\":\"Emanuela Resta, Giusi Graziano, Giacomo Riformato, Chiara Noviello, Silvio Tafuri, Paola Pierucci\",\"doi\":\"10.1159/000542908\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Natural history of chronic obstructive pulmonary disease (COPD) is characterized by a progressive decline in pulmonary function and recurrent exacerbations, requiring frequent hospital admissions to medical wards. Great heterogeneity still exists between studies hindering our understanding of the true, global burden of AECOPD on healthcare systems over COVID-19 pandemic. We aimed to describe the AECOPD in the southern Italian region from 2017 to 2022 and to detail the location of admission, rate and characteristics of deaths, and use of noninvasive respiratory supports.</p><p><strong>Methods: </strong>Retrospective, cross-sectional study carried out in collaboration with the Apulian Regional Observatory for Epidemiology over the second semester of 2023. Selected records with specific ICD-9 codes related to AECOPD and its clinical details, related complications, number of re-hospitalization, and noninvasive respiratory support use described as \\\"principal\\\" or \\\"secondary\\\" or \\\"other diagnosis\\\" were considered.</p><p><strong>Results: </strong>From 2017 to 2022, a total of 29,917 patients with AECOPD were admitted to hospital, and they generated a total of 44,260 hospitalizations. The male gender represented 60.9% of the total, mean age 77.1 ± 11.2 years. Deaths were 3,743, complicated by other comorbidities in 54% of cases. Readmissions rate was 8.5%. Deaths allocation was as follows: intensive care 37.7%, general medicine 33%, respiratory ward 13.5%, etc. Noninvasive respiratory supports were used in 47% of cases.</p><p><strong>Conclusion: </strong>This prolonged and deeply characterized clinical observation of AECOPD admissions, including COVID-19 pandemic years, in Apulia region, shows that they present at older age, affected by one\\\\more comorbidities with more severe disease requiring in almost half a percentage of cases the use of respiratory support (HFNC and NIV). However, the high rate of deaths highlights the urgent need to further support the most severe cases who deserve more tailored ward allocation and care management.</p>\",\"PeriodicalId\":21048,\"journal\":{\"name\":\"Respiration\",\"volume\":\" \",\"pages\":\"1-10\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-02-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiration\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000542908\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiration","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000542908","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Chronic Obstructive Pulmonary Disease Burden of Disease from 2017 to 2022: Analysis of 44,260 Hospitalizations in the Italian Apulian Region.
Introduction: Natural history of chronic obstructive pulmonary disease (COPD) is characterized by a progressive decline in pulmonary function and recurrent exacerbations, requiring frequent hospital admissions to medical wards. Great heterogeneity still exists between studies hindering our understanding of the true, global burden of AECOPD on healthcare systems over COVID-19 pandemic. We aimed to describe the AECOPD in the southern Italian region from 2017 to 2022 and to detail the location of admission, rate and characteristics of deaths, and use of noninvasive respiratory supports.
Methods: Retrospective, cross-sectional study carried out in collaboration with the Apulian Regional Observatory for Epidemiology over the second semester of 2023. Selected records with specific ICD-9 codes related to AECOPD and its clinical details, related complications, number of re-hospitalization, and noninvasive respiratory support use described as "principal" or "secondary" or "other diagnosis" were considered.
Results: From 2017 to 2022, a total of 29,917 patients with AECOPD were admitted to hospital, and they generated a total of 44,260 hospitalizations. The male gender represented 60.9% of the total, mean age 77.1 ± 11.2 years. Deaths were 3,743, complicated by other comorbidities in 54% of cases. Readmissions rate was 8.5%. Deaths allocation was as follows: intensive care 37.7%, general medicine 33%, respiratory ward 13.5%, etc. Noninvasive respiratory supports were used in 47% of cases.
Conclusion: This prolonged and deeply characterized clinical observation of AECOPD admissions, including COVID-19 pandemic years, in Apulia region, shows that they present at older age, affected by one\more comorbidities with more severe disease requiring in almost half a percentage of cases the use of respiratory support (HFNC and NIV). However, the high rate of deaths highlights the urgent need to further support the most severe cases who deserve more tailored ward allocation and care management.
期刊介绍：
''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.
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