Mortality of elderly patients in Ontario after hospital admission for chronic obstructive pulmonary disease.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is associated with significant mortality. It is currently the fourth leading cause of death in Canada and the world.


OBJECTIVE
To describe the mortality of elderly patients in Ontario after hospital admission for COPD.


METHODS
A retrospective cohort study was conducted using the Discharge Abstract Database from the Canadian Institute for Health Information. Patients aged 65 years and older who were admitted to hospital between 2001 and 2004 with primary discharge diagnoses labelled with International Classification of Diseases, Ninth Revision codes 491, 492 and 496 were included in the study.


RESULTS
Mortality rates were 8.81, 12.10, 14.53 and 27.72 per 100 COPD hospital admissions at 30, 60, 90 and 365 days after hospital discharge, respectively. Mortality also increased with age, and men had higher rates than women. No significant differences in mortality rates were found between different socioeconomic groups (P>0.05). Patients with shared care of a family physician or general practitioner and a specialist had significantly lower mortality rates than the overall rate (P<0.05), and their rates were approximately one-half the rate of patients with only one physician.


CONCLUSIONS
Hospitalization with COPD is associated with significant mortality. Patients who were cared for by both a family physician or general practitioner and a specialist had significantly lower mortality rates than those cared for by only one physician, suggesting that continuous and coordinated care results in better survival.
Care Research Group, Sunnybrook Health Sciences Centre, Toronto, Canada.
Jason X
JX
Nie
Li
L
Wang
Ross E G
RE
Upshur
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010821:Physicians, Family; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D015272:Pulmonary Medicine; D012017:Referral and Consultation; D012189:Retrospective Studies; D012737:Sex Factors; D012923:Social Class