RESUMEN
Purpose: Exacerbations of COPD (ECOPD) are a frequent cause of hospitalization that seemed to ameliorate during the COVID outbreak. We aimed to evaluate the clinical characteristics of COPD-related hospital admissions and mortality in relation to the presence of COVID-19. Patients and Methods: We conducted a case-control study of patients admitted in four teaching hospitals throughout Spain between March 15 and April 30, 2020. Hospital admissions of respiratory cause with and without PCR-proven SARS-CoV-2 infection in patients with COPD were evaluated. Baseline and episode-related clinical characteristics were analyzed. Logistic regression analysis was performed to evaluate the risk for mortality. Results: During the study period, 2101 patients were admitted for respiratory worsening, 1200 (57.1%) with COVID-19. A total of 228 (10.8%) were admitted due to COPD worsening, of whom 52 (22.8%) tested positive for COVID-19. COPD patients with COVID-19, when compared to those without COVID-19, were more frequently males with better lung function (FEV1 postbronchodilator 71% vs 46% respectively, p<0.001) and had higher mortality (44.9% vs 13.6% respectively, p<0.001) despite similar age, comorbidities, total days of hospitalization and admission to intensive care unit. COVID-19 and eosinopenia were the strongest risk factors for mortality in the multivariate analysis in the overall COPD population. Inhaled corticosteroid use was not associated to mortality. Conclusion: Hospitalizations for ECOPD without COVID-19 were more frequent than COPD with COVID-19 during the first outbreak, but the latter were associated with higher mortality and low eosinophil counts that warrant further analysis.
Asunto(s)
COVID-19 , Enfermedad Pulmonar Obstructiva Crónica , Estudios de Casos y Controles , Brotes de Enfermedades , Hospitalización , Humanos , Masculino , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , SARS-CoV-2 , España/epidemiologíaRESUMEN
OBJECTIVE: To describe the clinical characteristics and survival of patients diagnosed with bronchogenic carcinoma during the years 2000 and 2001 in a tertiary level hospital. PATIENTS AND METHODS: Data were collected from our hospital's tumor registry and validated with independent sources. Of all the patients diagnosed with or treated for bronchogenic carcinoma in our hospital, only those from our health care area were selected. RESULTS: During the 2-year study period, 482 patients were diagnosed. Of those, 91% were men. The mean (SD) age was 66.6 (9.65) years. Large cell carcinomas accounted for 29.4% of cases. Of all the cases of bronchogenic carcinoma, 41.3% were diagnosed in stage IV. Thirty percent of non-small cell carcinomas were classified as stage I, compared to 6% of small cell carcinomas (P< .001). The most frequent treatment was chemotherapy (42.1%) and 20% of patients underwent surgery. The overall 5-year survival rate was 13% (95% confidence interval [CI], 10%-16%), while survival was significantly lower in patients aged 68 years or older (95% CI, 3%-15%; P< .001) and in patients with small cell carcinoma (0%, P< .01). CONCLUSIONS: Our recent experience (2000-2001) confirmed the advanced age of patients with bronchogenic carcinoma, the frequency of diagnosis in advanced stages of the disease (41% in stage IV), and the low overall 5-year survival rate (13%).
Asunto(s)
Carcinoma Broncogénico/epidemiología , Neoplasias Pulmonares/epidemiología , Anciano , Carcinoma Broncogénico/mortalidad , Carcinoma Broncogénico/patología , Estudios Transversales , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Estudios Retrospectivos , Tasa de Supervivencia , Factores de TiempoRESUMEN
Objetivo: Describir las características clínicas y la supervivencia de los carcinomas broncogénicos (CB) diagnosticados durante los años 2000 y 2001 en un hospital terciario. Pacientes y métodos: La información se recogió de la base de datos del Registro de Tumores del hospital y se validó con fuentes independientes. De todos los pacientes con CB diagnosticados o tratados en nuestro centro, se seleccionó a los que provenían exclusivamente del área de salud correspondiente. Resultados: Se diagnosticaron 482 casos en los 2 años del estudio; un 90% de los pacientes eran varones. La edad media ± desviación estándar fue de 66,6 ± 9,65 años. El 29,4% eran CB de células grandes. El 41,3% de todos los CB se diagnosticaron en estadio IV. El 30% de los CB no microcíticos se clasificaron en estadio I, en comparación con el 6% de los CB microcíticos (p < 0,001). El tratamiento más frecuente fue la quimioterapia (42,1%); la cirugía se efectuó en el 20% de los casos. La supervivencia global a los 5 años fue de 13% (intervalo de confianza del 95%, 10-16%), y fue significativamente inferior (p < 0,001) en los pacientes con mayor edad (≥ 68 años), en quienes se cifró en un 9% (intervalo de confianza del 95%, 3-15), y en el CB microcítico (0%; p < 0,01). Conclusiones: Se confirma en nuestra reciente experiencia (2000-2001) la elevada edad de los pacientes con CB, el frecuente diagnóstico en estadios avanzados (estadio IV: 41%) y la deficiente supervivencia global a los 5 años (el 13% del global)
Objective: To describe the clinical characteristics and survival of patients diagnosed with bronchogenic carcinoma during the years 2000 and 2001 in a tertiary level hospital. Patients and Methods: Data were collected from our hospital´s tumor registry and validated with independent sources. Of all the patients diagnosed with or treated for bronchogenic carcinoma in our hospital, only those from our health care area were selected. Results: During the 2-year study period, 482 patients were diagnosed. Of those, 91% were men. The mean (SD) age was 66.6 (9.65) years. Large cell carcinomas accounted for 29.4% of cases. Of all the cases of bronchogenic carcinoma, 41.3% were diagnosed in stage IV. Thirty percent of non-small cell carcinomas were classified as stage I, compared to 6% of small cell carcinomas (P<.001). The most frequent treatment was chemotherapy (42.1%) and 20% of patients underwent surgery. The overall 5-year survival rate was 13% (95% confidence interval [CI], 10%-16%), while survival was significantly lower in patients aged 68 years or older (95% CI, 3%-15%; P<.001) and in patients with small cell carcinoma (0%, P<.01). Conclusions: Our recent experience (2000-2001) confirmed the advanced age of patients with bronchogenic carcinoma, the frequency of diagnosis in advanced stages of the disease (41% in stage IV), and the low overall 5-year survival rate (13%)