Seasonal Variations of COPD Exacerbations Call for Timely Preventive Measures, Study Suggests

Patients with chronic obstructive pulmonary disease (COPD) often have more acute episodes of symptom worsening (exacerbations) during the coldest months of the year — January, February, and March — resulting in higher hospitalization and mortality rates in the U.S., a study reports.

Findings also showed that an intensification of preventive treatments during these three months may have a positive impact on overall COPD mortality and hospital readmission rates as well as lower the economic burden on healthcare resources.

This research was recently presented at the CHEST Annual Meeting 2019 in New Orleans, in a poster titled “Seasonal Variations in Outcomes and Costs for COPD.”

COPD affects approximately 6% of the U.S. population. Given its high prevalence, COPD is associated with a considerable economic burden, which is estimated to increase to $49 billion annually by 2020.

Researchers reviewed data from the 2016 National Inpatient Sample and National Inpatient Database to gain a better understanding of seasonal variations in hospital admission rates due to COPD exacerbations, and its impact on healthcare resource utilization.

The study included data from a total of 530,229 COPD patients, with a mean age of 68 years.

Results showed that most of the hospital admissions during the year (33.69%) occurred in the first quarter (January, February, and March), and patients admitted during this period were more likely to be readmitted than patients hospitalized during any other time of the year.

Patients admitted during these three months also had poorer outcomes, longer stays in the hospital, and the highest mortality rates.

“The results of the study highlight the dramatic seasonal variation in rates of admissions for COPD exacerbation. Most admissions occur during the coldest months of the year … and are associated with the highest mortality rates. The greatest burden on healthcare resources is in Q1 [the first quarter of the year],” the researchers wrote.

In general, total hospitalization costs were comparable between January and September, and were higher during October and November. Still, hospitalization charges were higher during January, February, and March than in the following months.

“Looking toward the future, intelligent redistribution of resources will be needed to continue to meet the needs of patients with COPD in an already overburdened healthcare system,” Abhishek Chakraborti, MD, from the Brookdale Hospital and Medical Center and lead author of the study, said in a press release.

“Intensification of preventive treatments in the first quarter of the year should impact overall mortality and readmission rates while alleviating some of the strain on healthcare resources,” Chakraborti added.

According to the team, further research on the effects of air pollution levels, humidity, ambient temperature, and viral respiratory infections on COPD exacerbations during the winter months may help define target areas.

“This study calls into action several questions. It is important to identify factors that contribute to increased rates of COPD exacerbations during the winter months, possible biomarkers, patterns of COPD exacerbations, specific phenotypes that may identify those who are more susceptible to exacerbations during Q1 season and, of course, preventive interventions,” said Michelle Cao, MD, member of the American College of Chest Physicians’ scientific presentations and awards committee, and clinical associate professor at Stanford University.

“The study provides an opportunity to improve morbidity, mortality and economic burdens associated with COPD,” Cao concluded.