COPD Burden of disease from 2017 to 2022: analysis of 44260 hospitalization in the Italian Apulian region.

Abstract

Introduction Natural history of COPD is characterized by a progressive decline in pulmonary function and recurrent exacerbations, requiring frequent hospital admissions in medical wards. Great heterogeneity still exists between studies hindering our understanding of the true, global burden of AECOPD on healthcare systems over COVID19 pandemic. We aim to describe the AECOPD in souther Italian region from 2017-2022 and to detail the location of admission, rate and characteristics of deaths and use of noninvasive respiratory supports. Methods Retrospective, cross-sectional study carried out in collaboration with the Apulian Regional Observatory for Epidemiology over the second semester of 2023. Selected records with specific ICD9 codes related to AECOPD and its clinical details, related complications, number of re-hospitalization, and noninvasive respiratory supports use described as "principal" or "secondary" or "other diagnosis" were considered. Results From 2017 to 2022 a total of 29,917 patients with AECOPD were admitted in hospital and they generated a total of 44,260 hospitalization. The male gender represented 60.9% of total, mean age 77.1±11.2 years; Deaths were 3743, complicated by other comorbidities in 54% of cases. Readmissions rate was 8.5%. Deaths allocation was: Intensive care 37.7 %, General medicine 33%, Respiratory ward 13.5% etc. Noninvasive respiratory supports were used in 47% of cases. Discussion This prolonged and deeply characterized clinical observation of AECOPD admissions including COVID19 pandemic years in Apulia region shows that they present with older age, affected by onemore comorbidities with more severe disease requiring in almost half percentage of case the use of respiratory support ( HFNC and NIV). However, the high rate of deaths highlights the urgent need to further support the most severe cases who deserve more tailored ward allocation and care management.