Modification of COPD presentation during the last 25 years.
During the last decades progress has been made in the treatment of Chronic Obstructive Pulmonary Disease (COPD). We compared a random sample of patients admitted for an exacerbation in the period 2001-2005 (n = 101), with a random sample of patients hospitalized for the same reason in the period 1980-1984 (n = 51). Patients of the 2001-2005 cohort had a lower FEV1 (48 ± 3 vs. 41 ± 2% predicted, p = 0.01) for similar mean age, gender and body- mass index when compared to the historical sample. Co-morbidities, according to the Charlson's index, were more prevalent in the 2001-2005 cohort compared to the 1980-1984 cohort, with a reduction of hemoglobin (13.9 ± 0.2 gr/dl vs. 14.9 ± 0.2, p < 0.01) and higher prevalence of anemia in the most recent cohort. We found an increase in the use of cardiovascular drugs and respiratory medications over time with exception for the long-term use of oxygen. Despite lower FEV1 and more prevalent co-morbidities, no difference in length of hospitalization (13.6 ± 1.4 days vs. 12.7 ± 0.7 days, p = 0.52) and 30 months survival post-exacerbation was noted (66.6% vs. 69.3%, p = 0.85). Over the course of 20 years, the presentation of COPD patients admitted for an exacerbation seems to be changed towards a more severe phenotype with lower FEV1 and more co-morbidities. As the length of hospitalization and the overall survival were not different between the two samples, a currently improved management of COPD can be hypothesized.
Fremault
Antoine
A
University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium. antoine.fremault@uz.kuleuven.ac.be
Janssens
Wim
W
Beaucage
François
F
Celis
Geert
G
Pérez-Bogerd
Silvia
S
Decramer
Marc
M
D000368:Aged; D001530:Belgium / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors