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Presentations to emergency departments for chronic obstructive pulmonary disease in Alberta: a population-based study

Published online by Cambridge University Press:  21 May 2015

Rhonda J. Rosychuk*
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alta. Women and Children's Health Research Institute, Edmonton, Alta.
Donald C. Voaklander
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alta.
Ambikaipakan Senthilselvan
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alta.
Terry P. Klassen
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alta. Women and Children's Health Research Institute, Edmonton, Alta.
Thomas J. Marrie
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, NS
Brian H. Rowe
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alta. Department of Emergency Medicine, University of Alberta, Edmonton, Alta.
*
Department of Pediatrics, University of Alberta, 9423 Aberhart Centre, 11402 University Ave. NW, Edmonton AB T6G 2J3; [email protected]

Abstract

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Objective:

Chronic obstructive pulmonary disease (COPD) is a widespread illness with an increasing prevalence in older adults; exacerbations resulting in visits to the emergency department (ED) are common. We sought to determine the epidemiology of COPD presentations to EDs by older adults in Alberta.

Methods:

Administrative databases were used to examine all ED encounters for COPD from April 1999 to March 2005 in Alberta. Data included demographics of patients and timing of ED visits. Data analysis included descriptive summaries and age–sex directly standardized visit rates (DSVRs).

Results:

There were 85 330 ED visits for acute COPD made by 38 638 patients 55 years of age or older during the study period. More men (53.2%) presented, and the mean age at presentation was 72 years. The age–sex DSVRs remained stable from 2000/01 (24.4/1000) to 2004/05 (25.6/1000). Presentation rates differed among population subgroups. Overall, 67% of visits resulted in discharge from the ED.

Conclusion:

Chronic obstructive pulmonary disease is a common presentation in Alberta EDs; however, the rates of presentation were stable during the study period, and monthly and hourly trends exhibited similar patterns for each year. Disparities based on age, sex, and socio-economic and cultural statuses were identified. Targeted interventions could be implemented to reduce future ED visits for COPD.

Type
Original Research • Recherche originale
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

References

REFERENCES

1.O’Donnell, DE, Aaron, S, Bourbeau, J, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease — 2007 update. Can Respir J 2007;14 Suppl B:5B–32B.Google Scholar
2.Mannino, DM, Homa, DM, Akinbami, LJ, et al. Chronic obstructive pulmonary disease surveillance — United States, 1971–2000. MMWR SurveillSumm 2002;51:116.Google Scholar
3.Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2006. Available: http://www.who.int/respiratory/copd/GOLD_WR_06.pdf (accessed 2010 Sep. 17).Google Scholar
4.Alberta Health and Wellness. Ambulatory care in Alberta using Ambulatory Care Classification System data. Edmonton (AB): Alberta Health and Wellness; 2004.Google Scholar
5.International Classification of Diseases, 9th revision, clinical modification. 3rd ed. Washington (DC): US Department of Health and Human Services; 1989.Google Scholar
6.Canadian Institute for Health Information. The Canadian enhancement of ICD–10. Ottawa (ON): The Institute; 2001.Google Scholar
7.Colman, I, Dryden, DM, Thompson, AH, et al. Utilization of the emergency department after self-inflicted injury. Acad Emerg Med 2004;11:136–42.Google Scholar
8.Kelly, KD, Rowe, BH, Lissel, H, et al. Sport and recreation-related head injuries treated in the emergency department. Clin J Sport Med 2001;11:7781.Google Scholar
9.Voaklander, DC, Kelly, KD, Sukrani, N, et al. Sledding injuries presenting to the emergency department in a northern city. Acad Emerg Med 2001;8:629–35.CrossRefGoogle Scholar
10.Alberta Health and Wellness. Map of health regions prior to April 1, 2009. Available: http//www.health.alberta.ca/services /health-regions.html (accessed 2010 Feb. 9).Google Scholar
11.Indian and Northern Affairs Canada. Terminology. Available: http://www.ainc-inac.gc.ca/ap/tln-eng.asp (accessed 2009 Mar. 2).Google Scholar
12.Carriere, KC, Roos, LL. Comparing standardized rates of events. Am J Epidemiol 1994;140:472–82.Google Scholar
13.S-Plus Version 8.0.4 for Linux 2.4.2. Palo Alto (CA): TIBCO Software Inc.; 2007.Google Scholar
14.Tsai, C-L, Sobrino, JA, Camargo, CA Jr. National study of emergency department visits for acuteexacerbation of chronic obstructive pulmonary disease, 1993-2005. AcadEmerg Med 2008;15:1275–83.Google Scholar
15.Mannino, DM, Braman, S. The epidemiology and economics of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2007;4:502–6.CrossRefGoogle ScholarPubMed
16.Rowe, BH, Bond, K, Ospina, M, et al. Frequency, determinants, and impact of overcrowding in emergency departments in Canada: a national survey of emergency department directors. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2006.Google Scholar
17.Scott, S, Walker, P, Calverley, PMA. COPD exacerbations. 4: prevention. Thorax 2006;61:440–7.Google Scholar
18.Sin, DD, Wells, H, Svenson, LW, et al. Asthma and COPD among Aboriginals in Alberta, Canada. Chest 2002;121:1841–6.Google Scholar
19.Chapman, KR. Chronic obstructive pulmonary disease: Are women more susceptible than men? Clin Chest Med 2004;25: 331–41.Google Scholar
20.Cydulka, RK, Rowe, BH, Clark, S, et al. Gender differences in emergency department patients with COPD exacerbations. Acad Emerg Med 2005;12:1173–9.CrossRefGoogle Scholar
21.Radeos, MS, Cydulka, RK, Rowe, BH, et al. Validation of self-reported chronic obstructive pulmonary disease among patients in the ED. Am J Emerg Med 2009;27:191–6.Google Scholar
22.Stieb, DM, Beveridge, RC, Rowe, BH, et al. Assessing diagnostic classification in an emergency department: implications for daily time series studies of air pollution. Am J Epidemiol 1998;148:666–70.Google Scholar
23.Aaron, SD, Vandemheen, KL, Boulet, LP, et al. Overdiagnosis of asthma in obese and nonobese adults. CMAJ 2008;179:1121–31.Google Scholar
24.Rowe, BH, Cydulka, R, Tsai, CL, et al. Comparison of Canadian versus United States emergency department visits for chronic obstructive pulmonary disease exacerbation. Can Respir J 2008;15:295301.Google Scholar