[Mortality due to chronic obstructive pulmonary disease: indicators of impact, access to health services, and outcome of hospital treatment in an Italian region].
OBJECTIVE
to estimate mortality due to chronic obstructive pulmonary disease (COPD), risk of dying from COPD without hospital admission and mortality within 30 days after hospital admission for COPD in an Italian region.


METHODS
population registries of death causes and hospital discharge reports were used as data sources; COPD was identified through ICD-9 codes = 490.X, 491.X, 492.X, 494.Xe 496.X. Age-adjusted mortality rates were calculated by direct standardisation using the Italian population from 1996 to 2000; logistic regression was used to estimate predictors of dying from COPD in multivariable models.


RESULTS
there were 4,292 deaths among men and 2,713 among women; the mean annual mortality was 3.68/10,000 inhabitants among men and 2.29/10,000 among women.


CONCLUSIONS
no statistically significant trend was observed from 1996 to 2000, but the increase in mortality rate was higher for females (13.2%) than for males (2.0%), suggesting a possible inversion in smoking habit between sexes. The risk of dying without hospitalisation was higher for males who resided outside Rome (OR 1.65; CI 95% 1.04-2.62). Mortality within 30 days after hospitalisation was 4.2% among 25,046 patients. Patients who died were more likely to be over 54 and male, to have comorbidities or complications, hospitalised in general wards rather than pneumology or intensive care units, and have been on ventilation.
Faustini
Annunziata
A
Dipartimento di epidemiologia, ASL RME, Roma. faustini@asplazio.it
Marino
Claudia
C
Dovidio
Mariangela
M
Perucci
Carlo A
CA
D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000628:therapy; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies