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Canada: COPD-related hospitalisation among younger people rising

Annual hospital admissions for chronic obstructive pulmonary disease (COPD), which affects the lungs and progresses, resulting in frequent hospitalisation, have increased 69% in Canada since 2002, burdening patients, families, and health care systems, according to researchers in a new study published in the Canadian Medical Association Journal.

The study also discovered that women and younger people require these hospitalisations for conditions that are often linked to male smokers.

Pointing out that it is crucial to identify gaps in health care that lead to higher utilisation as pressure on Canada's health systems increases, Dr Kate Johnson, assistant professor, Faculty of Medicine and Faculty of Pharmaceutical Sciences at the University of British Columbia (UBC), said, "Hospital admissions for COPD may represent one such area for improvement as, in many instances, they could be avoided with proper preventive or early therapeutic interventions."

To better understand the situation, researchers from UBC, Providence Health Care Research Institute, and St. Paul's Hospital in Vancouver, British Columbia, examined national data on hospital admissions in Canada and found that between 2002 and 2017, there were 1,134,359 COPD hospitalisations in people aged 40 and up.

They further found that of the total admissions, 240,611 (21.2%) were for younger individuals aged 40–64 years, with females accounting for more than half (127,514 or 53.0%). The number of yearly hospital admissions for COPD grew by 68.8% over the 16-year research period, from 52,937 to 89,384.

After correcting for population growth, age, and gender, the hospital admission rate for COPD increased by about 10% (from 437 to 479 per 100,000 persons), whereas admission rates for other health issues fell. Admissions among younger girls increased the most (12.2%), followed by younger males (24.4%) and older females (29.8%), while admissions among older males decreased (9.0%).

"The number of hospital admissions for COPD has rapidly increased since 2010 in Canada. Even after adjusting for population growth and ageing, COPD admission rates have risen since 2010 in all groups except among older males. This is in contrast to declining all-cause admission rates over this period. Our findings call into question whether progress is being made in improving COPD care and outcomes," conclude the authors.

Suggesting that a variety of causes, including improved treatments that are extending the lives of COPD patients, increases in pneumonia and influenza rates, and changes in hospital admissions practices, could be driving the increase, the authors pointed out that changes in exposure to air pollution, wildfire smoke, or indoor hazardous inhalants may also be contributing to the increase.

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