Hospital admissions related to acute exacerbations of chronic obstructive pulmonary disease in France, 1998-2007.
BACKGROUND
Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) necessitating hospital admission have a major impact on patient outcome and management costs. We examined temporal trends in AE-COPD-related hospital admissions in France between 1998 and 2007.


METHODS
Data were obtained from the French national hospital discharge database for patients aged at least 25 years. AE-COPD was identified with both a "narrow" and a "broad" definition, according to the position (primary or associated) of diagnoses, in order to ensure robustness.


RESULTS
In 2007, among adults aged 25 years or more, the crude AE-COPD-related admission rates were 23/10000 in men and 10/10000 in women using the narrow definition. Using the broad definition, these rates were respectively 38 and 16/10000. With the narrow definition, the annual number of AE-COPD-related admissions increased by 38% between 1998 and 2007, while in-hospital lethality decreased from 7.6% to 6.0%. The proportion of male patients decreased from 72% to 68%. Similar trends were found using the broad definition. The age-standardized AE-COPD-related admission rate increased by 4.4% per year in women and by 1.6% per year in men with the narrow definition, and by respectively 3.8% and 1.2% with the broad definition. A strong seasonal pattern of admissions for AE-COPD was found, matching that of general practitioners visits for influenza-like illness.


CONCLUSIONS
Hospitalization rates for AE-COPD have increased in France in recent years, especially among women. By contrast, AE-COPD-related in-hospital lethality has decreased.
Institut de veille sanitaire, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France. c.fuhrman@invs.sante.fr
Claire
C
Fuhrman
Nicolas
N
Roche
Alain
A
Vergnenègre
Mahmoud
M
Zureik
Christos
C
Chouaid
Marie-Christine
MC
Delmas
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000191:economics / Q000453:epidemiology*