FOLLOWUS
1. 1Division of Pulmonology, Department of Medicine, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand
2. 2National Heath Security Office (NHSO), Region 12, Thailand
Received:05 May 2023,
Accepted:2023-6-26,
Published Online:23 July 2023,
Published:30 September 2023
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Narongwit Nakwan, Kanittha Suansan. In-hospital Mortality and Hospital Outcomes among Adults Hospitalized for Exacerbations of Asthma and COPD in Southern Thailand (2017-2021): A Population-Based Study[J]. Chinese medical sciences journal, 2023, 38(3): 228-234.
Narongwit Nakwan, Kanittha Suansan. In-hospital Mortality and Hospital Outcomes among Adults Hospitalized for Exacerbations of Asthma and COPD in Southern Thailand (2017-2021): A Population-Based Study[J]. Chinese medical sciences journal, 2023, 38(3): 228-234. DOI: 10.24920/004252.
背景
泰国因哮喘和慢性阻塞性肺疾病(COPD)恶化而住院的情况时有发生。住院治疗结果的全国性趋势对于医疗保健系统内预防策略的规划至关重要。本文研究了泰国南部因哮喘和COPD加重而住院的成人的住院结果的时间趋势,包括死亡率、住院时间(LOS)和报销费用。
方法
利用泰国南部国家卫生安全办公室提供的数据,对因哮喘和COPD加重而住院的成人进行了一项基于人群的回顾性研究。对2017年至2021年期间分别因哮喘和COPD住院的19
459例患者和66
457患者进行了基线人口统计学和住院结果评估。
结果
随着时间的推移,因哮喘和COPD加重而住院的人数显著减少,尤其是在2020/2021年。从2017年到2021年,哮喘的院内死亡率从每1
000例住院患者中有3.2例死亡上升到3.7例(
P
<
0.05)。另一方面,COPD的入院死亡率在2017年至2020年期间从每1000例住院患者20.3例死亡降至16.4例,但随后在2021年又增至21.8例(
P
<
0.05)。死亡率上升的主要原因是年龄的增长。不过,在研究期间,哮喘和COPD的平均住院时间都略有缩短。哮喘和CP{D每次住院的总费用显著增加,2020/2021 年的增幅尤为明显。
结论
2017-2021 年间,泰国哮喘和COPD加重继续在院内死亡率和报销费用中占据重要地位,但住院人数总体有所减少,住院时间也略有波动。
Background
Hospitalizations for asthma and chronic obstructive pulmonary disease (COPD) exacerbations frequently occur in Thailand. National trends in hospital outcomes are essential for planning preventive strategies within the healthcare system. We examined temporal trends in in-hospital outcomes
including mortality rate
length of stay (LOS)
and expenses for reimbursement in adults hospitalized for asthma and COPD exacerbations in southern Thailand.
Methods
A retrospective
population-based study on adults hospitalized for exacerbations of asthma and COPD was carried out using data from the National Health Security Office in southern Thailand. Baseline demographic and in-hospital outcome assessments were conducted on 19
459 and 66
457 hospitalizations for asthma and COPD
respectively
between 2017 and 2021.
Results
Significant reductions in hospital admissions for exacerbations of asthma and COPD were observed over time
particularly in 2020/2021. From 2017 to 2021
the in-hospital mortality rate for asthma rose from 3.2 to 3.7 deaths per 1
000 admissions (
P
<
0.05). The rates for COPD admissions
on the other hand
reduced from 20.3 to 16.4 deaths per 1
000 admissions between 2017 and 2020
but subsequently increased to 21.8 in 2021 (
P
<
0.05). The prominent contributor to the higher mortality rate was found to be increasing age. Nonetheless
the average LOS for both asthma and COPD decreased slightly over the study period. The total expenses for reimbursing exacerbations of asthma and COPD per hospitalisation have risen significantly each year
with a particularly notable increase in 2020/2021.
Conclusion
During 2017-2021
exacerbations of asthma and COPD in Thailand continued to account for significant in-hospital mortality rates and reimbursement expenses
despite the overall decrease in hospitalizations and slight fluctuations in the LOS.
Global Initiative for Asthma GINA . Global strategy for asthma management and prevention, updated 2023 . Available from http://www.ginasthma.org http://www.ginasthma.org http://www.ginasthma.org, 2022. Accessed: November 1, 2022.
Global Initiative for Chronic Obstructive Lung Disease GOLD . Global strategy for prevention, diagnosis and management of copd, updated 2022 . Available from https://goldcopd.org/2022-gold-report-2 https://goldcopd.org/2022-gold-report-2 https://goldcopd.org/2022-gold-report-2. Accessed: November 1, 2022.
Kaur BP , Lahewala S , Arora S , et al . Asthma: hospitalization trends and predictor of in-hospitality and hospitalization costs in the USA (2001-2010) [J]. Int Arch Allergy Immunol 2015 ; 168 : 71 - 8 . doi: 10.1159/000441687 https://dx.doi.org/10.1159/000441687 . https://www.karger.com/Article/FullText/441687 https://www.karger.com/Article/FullText/441687
Inmai PN , Liabsuetrakul T , Ichihara N , et al . Health effects of the asthma care program under the universal coverage scheme in children and young adults in Thailand [J]. Int J Environ Res Public Health . 2022 ; 19 ( 7 ): 4130 . doi: 10.3390/ijerph19074130 https://dx.doi.org/10.3390/ijerph19074130 . https://www.mdpi.com/1660-4601/19/7/4130 https://www.mdpi.com/1660-4601/19/7/4130
Lima FV , Yen TY , Patel JK . Trends in in-hospital outcomes among adults hospitalized with exacerbation of chronic obstructive pulmonary disease [J]. COPD 2015 ; 12 ( 6 ): 636 - 42 . doi: 10.3109/15412555.2015.1020151 https://dx.doi.org/10.3109/15412555.2015.1020151 .
Krishnan V , Diette GB , Rand CS , et al . Mortality in patients hospitalized for asthma exacerbations in the United States [J]. Am J Respir Crit Care Med. 2006 ; 174 ( 6 ): 633 - 8 . doi: 10.1164/rccm.200601-007OC https://dx.doi.org/10.1164/rccm.200601-007OC . https://www.atsjournals.org/doi/10.1164/rccm.200601-007OC https://www.atsjournals.org/doi/10.1164/rccm.200601-007OC
Kirenga BJ , de Jong C , Mugenyi L , et al . Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study [J]. Thorax 2018 ; 73 ( 10 ): 983 - 5 . doi: 10.1136/thoraxjnl-2017-211157 https://dx.doi.org/10.1136/thoraxjnl-2017-211157 .
Shah SA , Quint JK , Sheikh A . Impact of COVID-19 pandemic on asthma exacerbations: retrospective cohort study of over 500,000 patients in a national English primary care database [J]. Lancet Reg Health Eur. 2022 ; 19 : 100428 doi: 10.1016/j.lanepe.2022.100428 https://dx.doi.org/10.1016/j.lanepe.2022.100428 .
Chan KF , Kwok WC , Ma TF , et al . Territory-wide study on hospital admissions for asthma exacerbations in the COVID-19 pandemic [J]. Ann Am Thorac Soc 2021 ; 18 ( 10 ): 1624 - 33 . doi: 10.1513/AnnalsATS.202010-1247OC https://dx.doi.org/10.1513/AnnalsATS.202010-1247OC . https://www.atsjournals.org/doi/10.1513/AnnalsATS.202010-1247OC https://www.atsjournals.org/doi/10.1513/AnnalsATS.202010-1247OC
Poucineau J , Delory T , Lapidus N , et al . Hospital admissions and mortality for acute exacerbations of COPD during the COVID-19 pandemic: a nationwide study in France [J]. Front Med (Lausanne) 2022 ; 9 : 995016 . doi: 10.3389/fmed.2022.995016 https://dx.doi.org/10.3389/fmed.2022.995016 .
Alqahtani JS , Oyelade T , Aldhahir AM , et al . Reduction in hospitalised COPD exacerbations during COVID-19: a systematic review and meta-analysis [J]. PLoS One 2021 ; 16 ( 8 ): e0255659 . doi: 10.1371/journal.pone.0255659 https://dx.doi.org/10.1371/journal.pone.0255659 . https://dx.plos.org/10.1371/journal.pone.0255659 https://dx.plos.org/10.1371/journal.pone.0255659
Ekström M , Nwaru BI , Wiklund F , et al . Risk of rehospitalization and death in patients hospitalized due to asthma [J]. J Allergy Clin Immunol Pract 2021 ; 9 ( 5 ): 1960 - 8.e4 . doi: 10.1016/j.jaip.2020.12.030 https://dx.doi.org/10.1016/j.jaip.2020.12.030 .
Singanayagam A , Schembri S , Chalmers JD . Predictors of mortality in hospitalized adults with acute exacerbation of chronic obstructive pulmonary disease [J]. Ann Am Thorac Soc 2013 ; 10 ( 2 ): 81 - 9 . doi: 10.1513/AnnalsATS.201208-043OC https://dx.doi.org/10.1513/AnnalsATS.201208-043OC .
Sykes DL , Faruqi S , Holdsworth L , et al . Impact of COVID-19 on COPD and asthma admissions, and the pandemic from a patient’s perspective [J]. ERJ Open Res 2021 ; 7 ( 1 ): 00822 - 2020 . doi: 10.1183/23120541.00822-2020 https://dx.doi.org/10.1183/23120541.00822-2020 .
Sunjaya AP , Allida SM , Tanna GLD , et al . Asthma and COVID-19 risk: a systematic review and meta-analysis [J]. Eur Respir J 2022 ; 59 ( 3 ): 2101209 . doi: 10.1183/13993003.01209-2021 https://dx.doi.org/10.1183/13993003.01209-2021 . http://erj.ersjournals.com/lookup/doi/10.1183/13993003.01209-2021 http://erj.ersjournals.com/lookup/doi/10.1183/13993003.01209-2021
Pardhan S , Wood S , Vaughan M , et al . The Risk of COVID-19 related hospitalsation, intensive care unit admission and mortality in people with underlying asthma or COPD: a systematic review and meta-analysis [J]. Front Med (Lausanne) 2021 ; 8 : 668808 . doi: 10.3389/fmed.2021.668808 https://dx.doi.org/10.3389/fmed.2021.668808 .
Tydeman F , Pfeffer PE , Vivaldi G , et al . Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK) [J]. Thorax 2023 ; 78 ( 8 ): 752 - 9 . doi: 10.1136/thorax-2022-219591 https://dx.doi.org/10.1136/thorax-2022-219591 .
Ehteshami-Afshar S , FitzGerald JM , Doyle-Waters MM , et al . The global economic burden of asthma and chronic obstructive pulmonary disease [J]. Int J Tuberc Lung Dis 2016 ; 20 : 11 - 23 . doi: 10.5588/ijtld.15.0472 https://dx.doi.org/10.5588/ijtld.15.0472 .
Ford ES , Murphy LB , Khavjou O , et al . Total and state-specific medical and absenteeism costs of COPD among adults aged ≥18 years in the United States for 2010 and projections through 2020 [J]. Chest 2015 ; 147 ( 1 ): 31 - 45 . doi: 10.1378/chest.14-0972 https://dx.doi.org/10.1378/chest.14-0972 . https://linkinghub.elsevier.com/retrieve/pii/S0012369215302336 https://linkinghub.elsevier.com/retrieve/pii/S0012369215302336
Dalal AA , Shah M , D’Souza AO , et al . Costs of COPD exacerbations in the emergency department and inpatient setting [J]. Respir Med. 2011 ; 105 ( 3 ): 454 - 60 . doi: 10.1183/09059180.06.00009802 https://dx.doi.org/10.1183/09059180.06.00009802 .
Woo L , Smith HE , Sullivan SD . The economic burden of chronic obstructive pulmonary disease in the Asia-Pacific region: a systematic review [J]. Value Health Reg Issues 2019 ; 18 : 121 - 31 . DOI: S2212-1099(19)30046-9 http://doi.org/S2212-1099(19)30046-9
Lai CKW , Kim YY , Kuo SH , et al . Cost of asthma in the Asia-Pacific region [J]. Eur Respir Rev 2006 ; 15 ( 98 ): 10 - 6 . DOI: 10.1183/09059180.06.00009802 http://doi.org/10.1183/09059180.06.00009802 http://err.ersjournals.com/cgi/doi/10.1183/09059180.06.00009802 http://err.ersjournals.com/cgi/doi/10.1183/09059180.06.00009802
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