Abstract
Exacerbations of COPD are frequent and significant causes of hospital admissions. A G-DRG (German-diagnosis-related groups) database from the German Federal Statistical Office was analyzed. Data comprised all nationwide cases of insurance-claims for hospitalizations between 2005 and 2010. Cases with the primary diagnosis of COPD (ICD-10 code J44.x) or a primary diagnosis of respiratory failure (J96.x) combined with J44.x as a secondary diagnosis were included. To identify influential factors the 200 most frequent secondary diagnoses and OPS codes were determined.
A total of 995,044 hospitalizations (0.99 % of all hospitalizations) were due to COPD. 57 % of the patients were male. The overall mortality was 4.5 %. Invasive ventilation was performed in 3.0 % and non-invasive ventilation in 4.8 % of cases with mortality rates of 34.9 % and 17.1 %. Risk factors for mortality and need for ventilator therapy were determined by logistic regression (adjusted odds ratios (OR)). Aged and male patients are more frequently seen among fatal cases. Comorbidities such as acidosis (OR 3.11), anemia (2.99), acute respiratory (2.76) and heart failure (2.37) are related to a higher mortality and to a higher likelihood of ventilator therapy. During the observation period an increasing use of ventilator therapy and a rise of hours on ventilator therapy are seen. While the number of patients on invasive ventilation remains constant, cases of non-invasive ventilation become more frequent.
In summary, mortality due to COPD in German hospitals is high, with the outcome of a hospitalization being substantially influenced by factors such as comorbidities and ventilator therapy.
- © 2014 ERS