title: Chronic obstructive pulmonary disease (COPD) during the two last years of life--a retrospective study of decedents.
abstract: BACKGROUND
  Little is known about the management of patients suffering from chronic obstructive pulmonary disease (COPD) during the last years of life. The aim of the study was to describe how management of COPD is performed in Sweden during the last two years of life.
  
  
  METHODS
  From the nationwide Cause of Death register all individuals with COPD as the underlying cause of death during two years were identified in one sparsely and one densely populated area of Sweden. Data were collected from medical records using a pre-defined protocol, especially developed for this purpose.
  
  
  RESULTS
  Of 822 individuals with COPD as underlying cause of death, medical records from 729 were available. The COPD diagnosis was based on lung function measurements in approximately half of the patients and median age at COPD diagnosis was 74 years (range 34-95). Women died at younger age, median 78 years (range 52-96) than did men (80 years (51-99)). The median survival time from diagnosis to death was 6 years in men and women in both areas. Among women and men 8.3% and 4.3% were never smokers, respectively. The structure of COPD management differed between the two areas, with utilization of physiotherapists, dieticians and working therapists being more used in the northern area, likely because of differences in accessibility to care institutions.
  
  
  CONCLUSIONS
  In Sweden COPD is mostly diagnosed late in life and often not verified by lung function measurements. Opposite to the general population, women with COPD die at a lower age than men.
authors.affiliation: Lung and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Sundblad
authors.affiliation: Lung and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Lennarth
authors.initials: L
authors.lastname: Nyström
authors.affiliation: Astma/COPD, GlaxoSmithKline Sweden, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Arvidsson
authors.affiliation: Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
authors.affiliation: Lung and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Larsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012907:Smoking; D013548:Sweden / Q000453:epidemiology
chemical_list: D010100:Oxygen