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Comparison of in‐hospital mortality in patients with COPD , asthma and asthma– COPD overlap exacerbations
Author(s) -
Yamauchi Yasuhiro,
Yasunaga Hideo,
Matsui Hiroki,
Hasegawa Wakae,
Jo Taisuke,
Takami Kazutaka,
Fushimi Kiyohide,
Nagase Takahide
Publication year - 2015
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12556
Subject(s) - medicine , copd , asthma , exacerbation , odds ratio , confidence interval , body mass index , logistic regression
Background and objective Obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease ( COPD ), have airflow limitation associated with chronic inflammation. Using a national inpatient database in J apan, we aimed to evaluate factors affecting in‐hospital mortality in patients with asthma, COPD or asthma– COPD overlap ( ACO ). Methods We retrospectively collected data for inpatients (age >40 years) with exacerbation of COPD and/or asthma in 1073 hospitals across J apan between J uly 2010 and M ay 2013. We performed multivariable logistic regression analysis to examine the association of various factors with all‐cause in‐hospital mortality, including diagnosis of ACO , asthma alone and COPD alone. Results Of 30 405 eligible patients, in‐hospital mortality in patients with ACO , asthma alone and COPD alone was 2.3%, 1.2% and 9.7%, respectively. COPD patients had a significantly higher mortality than ACO patients (odds ratio 1.96; 95% confidence interval: 1.38–2.79); patients with asthma alone showed lower mortality (0.70; 0.50–0.97). Higher mortality was also significantly associated with older age, male gender, lower body mass index, more severe dyspnoea, lower level of consciousness, worse activities of daily life and higher daily dose of corticosteroids. Conclusion Asthma alone was associated with lower mortality, but COPD alone was associated with higher mortality than ACO .