Younger adults with COPD at higher health risk than previously thought

A population-based Canadian study found out younger adults with chronic obstructive pulmonary disease (COPD) needed healthcare much more than expected. Not only did they visit the emergency department almost as often as older COPD patients, but the height of their excess mortality rate was also unanticipated.

COPD is mostly seen as a condition of older individuals, but it is present as well in younger adults [1]. “It is commonly assumed that COPD diagnosed earlier in life equates a milder form of the disease,” indicated Dr Alina J. Blazer (University of Toronto, ON, Canada). Dr Blazer and her fellow researchers strove to investigate the burden of disease in terms of healthcare usage and mortality of younger COPD patients, as currently there is little evidence on this group’s real-world clinical features.

Healthcare administrative data from 14 million Ontarians between 2006 and 2016 was screened and all younger adults with COPD (aged 35­­ to 55) as well as older ones (>65 years) were identified. Furthermore, corresponding rates of individuals without COPD of the same age groups were included. ”For comparison of relative differences, the data presented here has been normalised to the rate for older adults without COPD as one,” informed Dr Blazer. The findings that both older and younger COPD patients needed healthcare more often than individuals without COPD was not unexpected. “However, we were surprised to find how elevated the rates were among younger adults,” said Dr Blazer. Looking at all-cause hospitalisations, older adults with COPD had a ~2-fold increase compared with those without COPD (see Figure). However, in the younger group, the rate was more than 3 times higher for the COPD patients compared with individuals without COPD. Also, for emergency department visits and outpatient visits, the rates of the younger adults with COPD surpassed those of the COPD-free correspondents. Dr Blazer pointed out that the rate of emergency department visits approached that of older adults with COPD. Concerning mortality, the rate of older adults with COPD was 2.5 times higher than in their comparison group. Remarkably, younger adults with COPD had a 5-fold amplified mortality rate when compared to those without COPD.

Figure: Rates of hospitalisation, emergency department, and outpatient visits in the different groups [1]



“This study provided further evidence that so-called early COPD is not necessarily a benign entity and suggests that we should focus clinical efforts on identifying COPD in younger patients in the hope that earlier intervention may improve their current health, reduce resource utilisation, and prevent further disease progression,” concluded Dr Blazer.

1. Blazer AJ. Excess Healthcare Utilization and Mortality in Younger Adults with COPD. Session C008: Innovations and updates in the study and management of COPD. ATS 2021 International Conference, 14-19 May.

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Posted on 5 July 2021