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首页> 外文期刊>COPD: Journal of Chronic Obstructive Pulmonary Disease >Acute exacerbations of COPD in the United States: Inpatient burden and predictors of costs and mortality
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Acute exacerbations of COPD in the United States: Inpatient burden and predictors of costs and mortality

机译：美国COPD急性加重：住院负担和费用及死亡率的预测因子

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摘要

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a leading cause of hospitalizations in the United States and the major cost driver of COPD. This study determined the national inpatient burden of AECOPD and assessed the association of co-morbidities and hospital characteristics with inpatient costs and mortality. Discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample for 2006 was utilized. Outcomes of costs and mortality were assessed for AECOPD hospitalizations in cases ≥40 years of age. Multivariate regression analyses using a generalized linear model framework were conducted to determine predictors of inpatient costs and mortality controlling for patient demographics, primary payer, co-morbidity index, length of stay, hospital region, mechanical ventilation, and admission period. Overall, 1,254,703 hospitalizations for AECOPD were observed with mean costs of $9545(±12,700) and total costs of $11.9 billion. In-hospital mortality was 4.3% (N = 53,748). Discharges averaged 70.6 (±11.9) years of age. The majority were female (52.8%) and of white race (83.6% of reported race). Several co-morbidities were significantly associated with both costs and mortality (p < 0.001): acute myocardial infarction; congestive heart failure; cerebrovascular disease; lung cancer; cardiac arrhythmias; pulmonary circulation disorders; and weight loss. Significantly higher costs (p < 0.001) were associated with large and urban hospitals. The importance of co-morbidities in AECOPD is indicated in their association with prognosis and inpatient costs. Future research should determine if better management of these conditions can favorably impact the COPD disease burden.
机译：慢性阻塞性肺疾病（AECOPD）的急性加重是美国住院的主要原因，也是COPD的主要成本驱动因素。这项研究确定了AECOPD在全国的住院负担，并评估了合并症和医院特征与住院费用和死亡率之间的关系。利用了美国医疗保健研究与质量局（AHRQ）的医疗费用和利用项目（HCUP）2006年全国住院病人样本的出院记录。对于≥40岁的病例，AECOPD住院治疗的成本和死亡率结果进行了评估。进行了使用广义线性模型框架的多元回归分析，以确定住院患者费用和死亡率的预测因素，以控制患者的人口统计，主要付款人，合并症，住院时间，医院区域，机械通气和入院时间。总体而言，AECOPD的住院治疗为1,254,703例，平均费用为$ 9545（±12,700），总费用为119亿美元。住院死亡率为4.3％（N = 53,748）。平均放电年龄为70.6（±11.9）岁。多数是女性（52.8％）和白人（占报道种族的83.6％）。几种合并症与费用和死亡率均显着相关（p <0.001）：急性心肌梗塞;充血性心力衰竭;脑血管疾病;肺癌;心律不齐;肺循环障碍;和减肥。大型医院和城市医院的费用明显较高（p <0.001）。 AECOPD中合并症的重要性与预后和住院费用相关。未来的研究应确定对这些疾病的更好管理是否可以有利地影响COPD疾病负担。

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