Evolution and Comparative Analysis of Hospitalizations in Spain Due to COPD and Bronchiectasis between 2004 and 2015

Figures & data

Figure 1. Flow chart of patient selection.

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.

Table 1. General characteristics of patients and hospitalizations.

		TOTAL n = 1 386 430	BE n = 116 783	COPD n = 1 181 610	Mixed n = 88 037	p-value
Age (mean ± SD)		74.8 (10.9)	74.9 (11.2)	74.7 (10.5)	74.6 (9.7)	<0.001
Male sex (% of patients)		80.1	49.7	82.9	81.9	<0.001
Type of admission (% of patients)	Urgent	95.7	93.9	95.9	95.7	<0.001
	Schedule	4.2	6	3.9	4.9
	Others	0.03	0.03	0.03	0.02
Readmission (% of patients)		17.1	16.6	16.8	21.9	<0.001
Length of stay, days (mean ± SD)		8.8 (8.2)	9.7 (8.6)	8.7 (8.2)	9.9 (8.7)	<0.001
Type of discharge (% of patients)	Home	89.2	91.5	88.8	91	<0.001
	Transfer to another hospital	2.1	1.5	2.1	1.7
	Voluntary discharge	0.3	0.2	0.3	0.2
	Transfer to another health center	1.1	0. 9	1.1	1.1
	Others	0.7	0.7	0.6	0.9
In-hospital mortality (% of patients)						<0.001
≤64 years		2.9	2.2	2.9	2.5
65-79 years		5.4	4.1	5.6	4.3
≥80 years		10.1	7.8	10.5	7.3
TOTAL		6.7	5.2	6.9	5.1

BE: bronchiectasis; SD: standard deviation; COPD: chronic obstructive pulmonary disease.

Figure 2. Temporal evolution of hospitalizations in each group, by sex and age ranges.

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.

Table 2. Temporal evolution of discharges between 2004 and 2015. Total number of hospitalizations each year, annual rate of admissions per 100,000 inhabitants, and percentage of interannual variation of the rate of hospitalizations for each group are indicated.

Year	Total (n)	Annual rate of admissions ^§	Interannual variation (%)	BE (n)	Annual rate of admissions ^§	Interannual variation (%)	COPD (n)	Annual rate of admissions ^§	Interannual variation (%)	Mixed (n)	Annual rate of admissions ^§	Interannual variation (%)
2004	107 417	248.7	–	7906	18.3	–	93 633	216.7	–	5878	13.6	–
2005	119 415	270.7	8.9	8526	19.3	5.6	104 344	236.6	9.1	6545	14.8	9
2006	107 299	240	−11.3	7899	17.7	−8.6	92 921	207.8	−12.1	6479	14.5	−2.3
2007	123 765	273.8	14.1	9253	20.5	15.9	107 331	237.4	14.2	7181	15.9	9.6
2008	119 244	258.3	−5.6	9300	20.1	−1.6	102 789	222.7	−6.2	7155	15.5	−2.4
2009	120 615	258	−0.1	9958	21.3	5.7	103 411	221.2	−0.7	7246	15.5	0
2010	113 957	242.3	−6.1	9586	20.4	−4.3	97 069	206.4	−6.7	7302	15.5	0.2
2011	115 538	244.8	1	10 096	21.4	4.9	98 095	207.9	0.7	7347	15.6	0.2
2012	115 469	244.3	−0.2	10 597	22.4	4.8	97 273	205.8	−1	7599	16.1	3.3
2013	109 864	233.1	−4.6	10 609	22.5	0.4	91 355	193.8	−5.8	7900	16.8	4.3
2014	113 108	241.8	3.7	11 284	24.1	7.2	93 553	200	3.2	8271	17.7	5.5
2015	120 739	258.9	7.1	11 769	25.2	4.6	99 836	214.1	7	9134	19.6	10.8
Total	1 386 430	–	0.6*	116 783	–	3.2*	1 181 610	–	0.2*	88 037	–	3.5*

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.

§ Annual rate of admissions per 100,000 inhabitants.

* Mean interannual variation of rate of admissions between 2004 and 2015.

Figure 3. Evolution of the mean length of stay by groups.

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.

Table 3. Bivariate and multivariate logistic regression analysis for mortality.

		Bivariate OR (IC95%)	Multivariate OR (IC95%)
Age ≥75		2.00 (1.90– 2.12)	2.02 (1.99 − 2.05)
Sex, n (%)	Male	Ref.	–
	Female	0.91 (0.75 − 1.10)
Group	COPD	Ref.	Ref.
	BE	0.74 (0.68 − 0.80)	0.73 (0.74 − 0.75)
	Mixed	0.71 (0.65 − 0.81)	0.71 (0.69 − 0.72)
Length of stay		1.03 (0.97 − 1.09)	–
Acute myocardial infarction	No	Ref.	–
	Yes	1 (0.97 − 1.01)
Heart failure	No	Ref.	Ref.
	Yes	1.79 (0.57 − 5.61)	1.56 (1.52-1.63)
Peripheral vascular disease	No	Ref.	–
	Yes	1.07 (0.94 − 1.21)
Cerebrovascular disease	No	Ref.	Ref.
	Yes	1.96 (0.52 − 7.32)	1.67 (1.60-1.75)
Dementia	No	Ref.	–
	Yes	2.95 (0.35 − 24.54)
Connective tissue diseases	No	Ref.	–
	Yes	0.99 (0.97 − 1.01)
Chronic renal failure	No	Ref.	–
	Yes	1.43 (0.71 − 2.85)
Solid tumors	No	Ref.	–
	YEs	1.57 (0.65 − 3.82)
Tumors with metastasis	No	Ref.	–
	Yes	1.28 (0.79 − 2.07)
Pneumococcus	No	Ref.	Ref.
	Yes	1.30 (1.28– 1.38)	1.32 (1.29-1.39)
Smoking	No	Ref.	–
	Yes	1.01 (0.14 − 1.90)
Oxygen therapy	No	Ref.	–
	Yes	1.29 (0.79 − 2.11)
Obesity	No	Ref.	–
	Yes	0.98 (0.85-1.02)
Charlson ≥3		2.23 (0.76 − 2.29)	2.05 (2.02 − 2.86)

Figure 4. Annual mortality rate between 2004 and 2015.

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.

Table 4. Bivariate and multivariate analysis for hospital length of stay. Poisson model.

		Bivariate OR (CI 95%)	Multivariate OR (CI 95%)
Age ≥ 75		1 (0.99 − 1.01)
Sex, n (%)	Male	Ref.	–
	Female	1.03 (0.98 − 1.10)
Group	COPD	Ref.	Ref.
	BE	1.2 (1.01 − 1.40)	1.3 (1.10 − 1.32)
	Mixed	1.1 (1.10 − 1.51)	1.2 (1.09 − 1.22)
Type of admission, n (%)	Urgent	Ref.	Ref.
	Schedule	0.8 (0.79 − 0.92)	0.8 (0.78 − 0.99)
	Others	1.4 (0.74 − 2.52)	0.9 (0.82 − 1.07)
Acute myocardial infarction	No	Ref.	–
	Yes	0.9 (0.83 − 1.06)
Heart failure	No	Ref.	–
	Yes	1.1 (0.92 − 1.30)
Peripheral vascular disease	No	Ref.	–
	Yes	1 (0.98 − 1.01)
Cerebrovascular disease	No	Ref.	–
	Yes	1.2 (0.90 − 1.40)
Dementia	No	Ref.	–
	Yes	1.1 (0.96 − 1.15)
Connective tissue diseases	No	Ref.	–
	Yes	1.1 (0.95 − 1.17)
Chronic renal failure	No	Ref.	–
	Yes	1.1 (0.95 − 1.18)
Solid tumors	No	Ref.	–
	Yes	1.04 (0.97 − 1.11)
Tumors with metastasis	No	Ref.	–
	Yes	1.02 (0.98 − 1.05)
Pneumococcus	No	Ref.	Ref.
	Yes	1.2 (1.02 − 1.53)	1.3 (1.11 − 1.58)
Smoking	No	Ref.	–
	Yes	0.9 (0.68 − 1.13)
Oxygen therapy	No	Ref.	Ref.
	Yes	1.1 (1.01 − 1.23)	1.2 (1.05 − 1.22)
CHARLSON ≥ 3		1.2 (1.01 − 1.10)	1.4 (1.39 − 1.49)

Table 5. Cost of hospitalizations: Global annual cost of admissions in each group and interannual cost variation.

	BE		COPD		Mixed
Year	Global cost	Interannual variation (%)	Global cost	Interannual variation (%)	Global cost	Interannual variation (%)
2004	31 314 559	–	381 314 774	–	23 937 802	–
2005	32 355 317	3.3	409 359 250	7.4	25 677 147	7.3
2006	28 095 874	−13.2	347 277 370	−15.2	24 214 225	−5.7
2007	34 074 265	21.3	413 387 493	19.0	27 657 765	14.2
2008	36 658 740	7.6	420 213 766	1.7	29 250 498	5.8
2009	39 657 037	8.2	427 295 286	1.7	29 940 544	2.4
2010	34 464 258	−13.1	369 793 091	−13.5	27 817 626	−7.1
2011	37 857 476	9.8	384 744 285	4.0	28 816 109	3.6
2012	37 882 473	0.1	367 940 958	−4.4	28 743 673	−0.3
2013	43 938 658	16.0	392 263 753	6.6	33 921 336	18
2014	44 043 257	0.2	378 993 493	−3.4	33 506 730	−1.2
2015	48 606 911	10.4	427 711 401	12.9	39 131 334	16.8
TOTAL	448 948 829	4,6*	4 720 294 924	1.5*	352 614 794	4.9*

BE: bronchiectasis; COPD: chronic obstructive pulmonary disease.