04. Alina Blazer

Excess healthcare utilization and mortality in younger adults with COPD.

5 Comments

  • Kenneth Wu says:

    This is a very interesting piece of work. What are the causes of COPD in young people? Smoking?

    • Alina Blazer says:

      Thank you! The causes in younger adults are heterogenous, as in older adults. Smoking is certainly the major cause of COPD, even in younger adults. Other causes (or contributors in susceptible individuals) may include pollution exposure (particularly indoor air pollution or occupational exposures) and longstanding untreated asthma leading to permanent obstruction. There may be predisposing features as well, for example, airway dysanapsis or incomplete attainment of potential lung growth.

  • Matthew Binnie says:

    Very good poster. The data are interesting but can be interpreted in different ways. i.e. that among patients with COPD the younger ones have relatively low rates of hospitalization and much lower mortality.
    Are the operating characteristics of the COPD definitions different in younger patients i.e. less specific?
    Given that you looked at all cause hospitalizations and mortality, to what extent do the differences between younger and older patients relate to comorbidities?

    • Alina Blazer says:

      Thanks Dr. Binnie. Great questions.
      The health administrative definition of COPD diagnosis used in this study was validated in a population that did contain individuals in the 35-55 age group albeit fewer than older adults, which may reduce specificity. While using a health administrative case definition can be subject to some misclassification, it also does represent the “real world” of which patients are being clinically treated as COPD, and is thus still valid to look at outcomes in those patients.

      In terms of your second question, I believe comorbidities likely play a significant role in the difference, but don’t have all the data to determine the extent. We know that risk factors for COPD (i.e. smoking) are also risk factors for additional comorbidities, (ie. cardiovascular disease) that may manifest at a younger age. I do have data on cardiovascular hospitalizations in the COPD and non-COPD populations (not shown here) and the rates of CV hospitalization among younger adults with COPD are also elevated compared to the non-COPD population, suggesting that this could play a role. Unfortunately, I don’t have any data on cause of death though to completely explain the difference in mortality.

  • Anne Stephenson says:

    Really interesting work Alina! Great poster also. Well done!

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