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COPD Patients Have Lower Survival, Increased Costs After Surgery

Association between COPD and outcomes modified by frailty, cancer, and procedure type

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 17, 2023 (HealthDay News) — Patients with chronic obstructive pulmonary disease (COPD) undergoing elective surgery have lower survival and increased costs in the year following surgery, according to a study published online Jan. 17 in CMAJ, the journal of the Canadian Medical Association.

Ashwin Sankar, M.D., from St. Michael’s Hospital in Toronto, and colleagues conducted a retrospective population-based cohort study involving patients undergoing elective surgery from 2005 to 2019. COPD status was ascertained using validated definitions. Survival and costs to the health system were evaluated in the year after surgery.

Data were included for 932,616 patients, 18 percent of whom had COPD. The researchers found that COPD had a partially adjusted hazard ratio of 1.61 and a fully adjusted hazard ratio of 1.26 with respect to the association with risk for death. COPD was associated with a partially adjusted relative increase of 13.1 percent and a fully adjusted increase of 4.6 percent with respect to the impact on health system costs. The association between COPD and outcomes was modified by frailty, cancer, and procedure type.

“Perioperative patient care should include comprehensive assessment and treatment tailored not only to COPD, but also to management of concomitant conditions and surgical disease,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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