The impact of hospitalised patients with COPD: from admission to outcome
Introduction
Data Coverage
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Chronic obstructive pulmonary disease (COPD) is a debilitating lung condition characterised by progressive lung function limitation. COPD is an umbrella term and encompasses a spectrum of pathophysiologies including chronic bronchitis, small airways disease and emphysema. COPD caused an estimated 3 million deaths worldwide in 2016, and is estimated to be the third leading cause of death worldwide. People with COPD experience flares in their symptoms, termed exacerbations. Exacerbations are associated with increased mortality, morbidity, a faster decline in lung function and other systemic illness such as heart attacks and strokes. Despite this impact, COPD exacerbations are poorly characterised and have been without novel treatments for >30 years.
PIONEER geography
The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. The West Midlands has a high prevalence of COPD, reflecting the high rates of smoking and industrial exposure. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS.
EHR
University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.
Scope
All hospitalised patients admitted to UHB with an exacerbation of COPD from Jan 2000 - 2021. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes ICD-10 & SNOMED-CT codes pertaining to COPD and COPD exacerbations, as well as all co-morbid conditions. Serial, structured data pertaining to process of care (timings, staff grades, specialty review, wards), presenting complaint, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (NIV, nebulisers, antibiotics), all outcomes. Linked images available (radiographs, CT).
