Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients.
Author
Waeijen-Smit, KikiCrutsen, Mieke
Keene, Spencer
Miravitlles, Marc
Crisafulli, Ernesto
Torres, Antoni
Mueller, Christian
Schuetz, Philipp
Ringbæk, Thomas J
Fabbian, Fabio
Mekov, Evgeni
Harries, Timothy H
Lun, Chung-Tat
Ergan, Begum
Esteban, Cristóbal
Quintana Lopez, Jose M
López-Campos, José Luis
Chang, Catherina L
Hancox, Robert J
Shafuddin, Eskandarain
Ellis, Hollie
Janson, Christer
Suppli Ulrik, Charlotte
Gudmundsson, Gunnar
Epstein, Danny
Dominguez, José
Lacoma, Alicia
Osadnik, Christian
Alia, Inmaculada
Spannella, Francesco
Karakurt, Zuhal
Mehravaran, Hossein
Utens, Cecile
de Kruif, Martijn D
Ko, Fanny Wai San
Trethewey, Samuel P
Turner, Alice M
Bumbacea, Dragos
Murphy, Patrick B
Vermeersch, Kristina
Zilberman-Itskovich, Shani
Steer, John
Echevarria, Carlos
Bourke, Stephen C
Lane, Nicholas
de Batlle, Jordi
Sprooten, Roy T M
Russell, Richard
Faverio, Paola
Cross, Jane L
Prins, Hendrik J
Spruit, Martijn A
Simons, Sami O
Houben-Wilke, Sarah
Franssen, Frits M E
Publication date
2024-02-26Subject
Respiratory medicine
Metadata
Show full item recordAbstract
Background: Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods: A systematic review was performed identifying studies that reported in-hospital mortality, post-discharge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results: Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisations <12 months prior to the index event. Conclusions: This IPDMA stresses the poor outcomes and high heterogeneity of ECOPD-related hospitalisation across the world. Whilst global standardisation of the management and follow-up of ECOPD-related hospitalisation should be at the heart of future implementation research, policy makers should focus on reimbursing evidence-based therapies that decrease (recurrent) ECOPD.Citation
Waeijen-Smit K, Crutsen M, Keene S, Miravitlles M, Crisafulli E, Torres A, Mueller C, Schuetz P, Ringbæk TJ, Fabbian F, Mekov E, Harries TH, Lun CT, Ergan B, Esteban C, Quintana Lopez JM, López-Campos JL, Chang CL, Hancox RJ, Shafuddin E, Ellis H, Janson C, Suppli Ulrik C, Gudmundsson G, Epstein D, Dominguez J, Lacoma A, Osadnik C, Alia I, Spannella F, Karakurt Z, Mehravaran H, Utens C, de Kruif MD, Ko FWS, Trethewey SP, Turner AM, Bumbacea D, Murphy PB, Vermeersch K, Zilberman-Itskovich S, Steer J, Echevarria C, Bourke SC, Lane N, de Batlle J, Sprooten RTM, Russell R, Faverio P, Cross JL, Prins HJ, Spruit MA, Simons SO, Houben-Wilke S, Franssen FME. Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients. ERJ Open Res. 2024 Feb 26;10(1):00838-2023. doi: 10.1183/23120541.00838-2023. PMID: 38410700; PMCID: PMC10895439.Type
ArticlePMID
38410700Journal
ERJ Open ResearchPublisher
European Respiratory Societyae974a485f413a2113503eed53cd6c53
10.1183/23120541.00838-2023