+
MODEL
Respiratory Medicine (2014) xx, 1e1
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/rmed
LETTER TO THE EDITOR
Trends of hospital admissions for acute exacerbation of COPD in Spain: Additional studies are needed
Dear Editor We have read with interest the letter to the editor published by Esquinas et al. [1] in reference to our article entitled “Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010” [2]. We would like to make several considerations. From CMBD data, we cannot estimate the prevalence of chronic obstructive pulmonary disease (COPD). However, other studies have showed that COPD prevalence has increased over time, although the rate of increase in recent years has declined, particularly among men [3]. Consequently, the decreased incidence of hospital admissions for acute exacerbations of COPD (AE-COPD) is valuable itself and should not be considered as result of a decline in COPD prevalence. Moreover, the factors pointed by Esquinas et al. to justify the lack of variation in the median length of hospital stay (LOHS) are possible, but there are others reasons that should be considered, as we mentioned in our article. Increased comorbidity may be responsible for the lack of decline in the LOHS in patients admitted for COPD exacerbation during the study period. In this regard, a recent study has shown that factors related to the duration of the average LOHS for these patients include some comorbidities such as heart failure, diabetes and stroke [4]. In any case, we agree with Esquinas et al. that the use of some types of cares, such as intensive intermediary care units, respiratory intermediary care units and home non-invasive ventilatory units, could help to reduce the average LOHS of patients hospitalized for EA-COPD. Finally, we also believe that further longitudinal studies, including more variables, are needed to clarify these results.
DOI of original j.rmed.2014.01.015.
article:
References [1] Esquinas AM, Zamarro Garcı´a C, Rey Terro ´n L. Trends of hospital admissions for acute exacerbation of COPD in Spain: are we needing a new of hospital and health system organization reappraisal? Respir Med; 2014 [in press]. [2] de Miguel-Dı´ez J, Jime ´nez-Garcı´a R, Herna ´ndez-Barrera V, Puente-Maestu L, Rodrı´guez-Rodrı´guez P, Lo ´pez de Andre ´s A, Carrasco-Garrido P. Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010. Respir Med 2013;107:717e23. [3] Rycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: a literature review. Int J Chron Obstruct Pulmon Dis 2012;7:457e94. [4] Wang Y, Stavem K, Dahl FA, Humerfelt S, Haugen T. Factors associated with a prolonged length of stay after acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Int J Chron Obstruct Pulmon Dis 2014;9:99e105.
Javier de Miguel-Dı´ez* Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran˜o´n, Universidad Complutense, Madrid, Spain Rodrigo Jime ´nez-Garcı´a Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorco´n, Madrid, Spain Luis Puente-Maestu Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran˜o´n, Universidad Complutense, Madrid, Spain *Corresponding author. Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran ˜o ´n, C/ Doctor Esquerdo 46, 28007 Madrid, Spain. E-mail address: [email protected] (J. de Miguel-Dı´ez) 2 February 2014
http://dx.doi.org/10.1016/
http://dx.doi.org/10.1016/j.rmed.2014.04.012 0954-6111/ª 2014 Elsevier Ltd. All rights reserved.
Please cite this article in press as: de Miguel-Dı´ez J, et al., Trends of hospital admissions for acute exacerbation of COPD in Spain: Additional studies are needed, Respiratory Medicine (2014), http://dx.doi.org/10.1016/j.rmed.2014.04.012
MODEL
Respiratory Medicine (2014) xx, 1e1
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/rmed
LETTER TO THE EDITOR
Trends of hospital admissions for acute exacerbation of COPD in Spain: Additional studies are needed
Dear Editor We have read with interest the letter to the editor published by Esquinas et al. [1] in reference to our article entitled “Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010” [2]. We would like to make several considerations. From CMBD data, we cannot estimate the prevalence of chronic obstructive pulmonary disease (COPD). However, other studies have showed that COPD prevalence has increased over time, although the rate of increase in recent years has declined, particularly among men [3]. Consequently, the decreased incidence of hospital admissions for acute exacerbations of COPD (AE-COPD) is valuable itself and should not be considered as result of a decline in COPD prevalence. Moreover, the factors pointed by Esquinas et al. to justify the lack of variation in the median length of hospital stay (LOHS) are possible, but there are others reasons that should be considered, as we mentioned in our article. Increased comorbidity may be responsible for the lack of decline in the LOHS in patients admitted for COPD exacerbation during the study period. In this regard, a recent study has shown that factors related to the duration of the average LOHS for these patients include some comorbidities such as heart failure, diabetes and stroke [4]. In any case, we agree with Esquinas et al. that the use of some types of cares, such as intensive intermediary care units, respiratory intermediary care units and home non-invasive ventilatory units, could help to reduce the average LOHS of patients hospitalized for EA-COPD. Finally, we also believe that further longitudinal studies, including more variables, are needed to clarify these results.
DOI of original j.rmed.2014.01.015.
article:
References [1] Esquinas AM, Zamarro Garcı´a C, Rey Terro ´n L. Trends of hospital admissions for acute exacerbation of COPD in Spain: are we needing a new of hospital and health system organization reappraisal? Respir Med; 2014 [in press]. [2] de Miguel-Dı´ez J, Jime ´nez-Garcı´a R, Herna ´ndez-Barrera V, Puente-Maestu L, Rodrı´guez-Rodrı´guez P, Lo ´pez de Andre ´s A, Carrasco-Garrido P. Trends in hospital admissions for acute exacerbation of COPD in Spain from 2006 to 2010. Respir Med 2013;107:717e23. [3] Rycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: a literature review. Int J Chron Obstruct Pulmon Dis 2012;7:457e94. [4] Wang Y, Stavem K, Dahl FA, Humerfelt S, Haugen T. Factors associated with a prolonged length of stay after acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Int J Chron Obstruct Pulmon Dis 2014;9:99e105.
Javier de Miguel-Dı´ez* Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran˜o´n, Universidad Complutense, Madrid, Spain Rodrigo Jime ´nez-Garcı´a Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorco´n, Madrid, Spain Luis Puente-Maestu Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran˜o´n, Universidad Complutense, Madrid, Spain *Corresponding author. Servicio de Neumologı´a, Hospital General Universitario Gregorio Maran ˜o ´n, C/ Doctor Esquerdo 46, 28007 Madrid, Spain. E-mail address: [email protected] (J. de Miguel-Dı´ez) 2 February 2014
http://dx.doi.org/10.1016/
http://dx.doi.org/10.1016/j.rmed.2014.04.012 0954-6111/ª 2014 Elsevier Ltd. All rights reserved.
Please cite this article in press as: de Miguel-Dı´ez J, et al., Trends of hospital admissions for acute exacerbation of COPD in Spain: Additional studies are needed, Respiratory Medicine (2014), http://dx.doi.org/10.1016/j.rmed.2014.04.012
