COPD Exacerbation Profile in Chile: Preliminary Results from Integramedica Cohort 2018-2020

ABSTRACT

Objectives: To describe demographic characteristics, comorbidities, and exacerbations in a cohort of patients with COPD in Chile. Method(s) Retrospective cohort study using INTEGRAMEDICA (a network of ambulatory medical centers) electronic medical records of patients with COPD aged >=40 years at index with data available one year before (baseline) and after (follow-up) index. Index date was fixed at 28-Feb-2019 to avoid including data from the COVID-19 pandemic. Moderate and severe exacerbations were defined as prescription of systemic corticosteroid/antibiotics and emergency visit/hospitalization, respectively. Result(s) In total, 19,000 patients were included. In the baseline period, 86% (n=16,400) had no moderate or severe exacerbations (NMSE), 13% (n=2,503) had only moderate exacerbations (OME) and <1% (n=96) had >=1 severe exacerbation (SEV). Mean age/proportion of females was 64 years/60% (total cohort), 65 years/59% (NMSE), 61 years/67% (OME) and 73 years/62% (SEV). The four most frequent comorbidities were hypertension (total 17.6%;NMSE 16.2%;OME 26.0%;SEV 24.0%), asthma (total 8.9%;NMSE 7.8%;OME 15.3%;SEV 17.7%), diabetes type 1/2 (total 6.3%;NMSE 5.9%;OME 9.1%;SEV 7.3%) and congestive heart failure (total 3.2%;NMSE 3.2%;OME 2.9%;SEV 4.2%). The proportion of patients with >=1 moderate/severe exacerbation during follow-up was 14% (total), 10% (NMSE), 38% (OME) and 35% (SEV). The severe exacerbation rate was 2.00 per 1,000 person-years in the overall population and increased based on exacerbation history (NMSE 0.91;OME 1.60;SEV 197.92) Conclusion(s) Preliminary results indicate that severe exacerbations were more frequent in patients with a history of SEV compared with patients with a history of OME or NMSE. In addition, comorbidities were more frequent in patients with a history of exacerbation. To improve patient health outcomes, strategies with a multisectoral approach should be prioritized as COPD can coexist with, and be aggravated by, other chronic comorbidities. Funding(s)GSK [209968].Copyright © 2023