Hospital discharges, readmissions, and ED visits for COPD or bronchiectasis among US adults: findings from the nationwide inpatient sample 2001-2012 and Nationwide Emergency Department Sample 2006-2011.
Hospital discharges, readmissions, and ED visits for COPD or bronchiectasis among US adults: findings from the nationwide inpatient sample 2001-2012 and Nationwide Emergency Department Sample 2006-2011.
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作者：
Ford ES
COPD患者的住院和艾德访视次数和比率是监测目的的重要指标。本研究的目的是检查2001年至2012年美国≥ 18岁成人中这些发生率的趋势。对来自全国住院患者样本（NIS）和全国急诊科样本（NEDS）的数据进行了检查，以了解COPD或支气管扩张患者住院人数和比率、平均住院时间、住院病死率、30天再入院率以及艾德就诊人数和比率的时间趋势。2012年，全国以COPD或支气管扩张为主要诊断的出院人数比2001年增加了约88，000人，但年龄调整后的出院率没有显著变化（范围为242.7-286.0/100，000人，P趋势= 0.554）。相比之下，常见心血管疾病、肺炎和肺癌的住院率显著下降了27%至68%，而平均费用增加了一倍，平均成本增加了40%。从2006年到2011年，艾德就诊人数从1 480 363人增加到1 787 612人。年龄调整率从每10万人654人增加到725人，但无显著性差异（P趋势= 0.072）。尽管许多地方和国家努力减轻COPD的负担，但在过去十年中，COPD的总住院率和艾德就诊率有所增加，在美国，COPD或支气管扩张的年龄调整后住院率和艾德就诊率没有显著变化。
Numbers and rates of hospitalizations and ED visits by patients with COPD are important metrics for surveillance purposes. The objective of this study was to examine trends in these rates from 2001 to 2012 among adults aged ≥ 18 years in the United States. Data from the Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) were examined for temporal trends in the numbers and rates of hospitalizations by patients with COPD or bronchiectasis, mean length of stay, in-hospital case-fatality rate, 30-day readmission rate, and numbers and rates of ED visits. The national number of discharges with COPD or bronchiectasis as the principal diagnosis was about 88,000 higher in 2012 than in 2001, but the age-adjusted rate of discharges did not change significantly (range, 242.7-286.0 per 100,000 population, P trend = .554). In contrast, hospitalization rates for common cardiovascular disorders, pneumonia, and lung cancer decreased significantly by 27% to 68%, whereas the mean charge doubled and mean cost increased by 40%. From 2006 to 2011, the numbers of ED visits increased from 1,480,363 to 1,787,612. The age-adjusted rate increased nonsignificantly from 654 to 725 per 100,000 population (P trend = .072). Despite many local and national efforts to reduce the burden of COPD, total hospitalizations and ED visits over the past decade have increased for COPD, and the age-adjusted rates of hospitalizations and ED visits for COPD or bronchiectasis have not changed significantly in the United States.