Characteristics and outcomes of hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD)

RATIONALE: Up to 25% of AECOPD events require hospitalization. However, data on AECOPD hospitalizations, including seasonal patterns, health resource use (HRU) and post-discharge readmission is limited. This study describes the characteristics and outcomes of AECOPD treated in US hospitals. METHODS: A retrospective study of COPD patients treated in 376 US hospitals for AECOPD from 2007-2010 was conducted with the Premier Perspective® database. All AECOPD hospitalizations for COPD patients aged 40-85 years were identified. Characteristics of AECOPD hospitalizations (including seasonal patterns, length of stay [LOS], proportions admitted to ICU and treated with ventilator, and in-hospital mortality) and 30- to 90-day post-discharge readmission were summarized. RESULTS: Of 285,752 AECOPD hospitalizations identified, most were found in the winter season (December-March, range 9.2-10.3%), peaking in March (10.3%); while the fewest were found in the summer season (June-September, range 6.5-7.5%), dipping in August (6.5%). Median LOS was 4 days; 20.5% included ICU admission and 12.9% required ventilator use. In-hospital mortality was 3.3% overall; 10.6% and 1.5% with and without an ICU stay, respectively; and 13.9% and 1.8% with and without ventilator use, respectively. Within 30, 60 and 90 days after discharge, readmission rates to the same hospital were 10.4%, 14.6% and 17.4%, respectively. CONCLUSONS: AECOPD-related hospitalizations are most prevalent from December to March and represent substantial healthcare burden by high readmission rates, substantial HRU, and resulting mortality. Early preventive treatment may reduce disease burden of AECOPD events.