Why some people with COPD and asthma are more likely to need hospital care

Background 

People living with long-term lung conditions, including asthma and COPD, may experience serious flare-ups that require hospital treatment. Some people also have a higher risk of dying from their disease. Understanding what factors increase these risks can help patients and healthcare teams prevent hospital visits and stay healthier. 

What did the study look at?

Researchers analysed healthcare records from over one million adults in Belgium who were taking medication for COPD or asthma between 2017 and 2022. They wanted to find out which factors were linked with a higher chance of a hospital visit or death. 

What did the results show? 

During the study, about 1 in 25 people had a flare-up that required a hospital visit, and about 1 in 7 people died. The study identified several factors that increased the risk, including: 

• Previous flare-ups: people who had a recent hospital visit for an exacerbation were much more likely to have another one 

• Smoking: people who smoked had a higher risk of both hospitalisation and death 

• Overusing reliever inhalers: People using more than six inhalers a year were more likely to have a flare-up or die. Frequent use of reliever inhalers may indicate that symptoms are not well controlled. These inhalers help open the airways temporarily but do not treat the underlying inflammation, so the disease can progress and the risk of flare-ups rises. 

• Frailty: people who were frail had a higher risk of death 

• Other factors: older age, having several other long-term health problems and lower socioeconomic status were also linked to higher risk. 

Why is this important for patients?

While some risk factors, like age, cannot be changed, many others are manageable. By understanding personal risks, patients and healthcare teams can take practical steps to reduce the chance of flare-ups or hospital visits. 

This might include reviewing care plans after flare-ups, quitting smoking, achieving effective control of symptoms or maintaining strength and activity. Discussing these risks openly with healthcare teams can help patients set realistic goals and create strategies to stay healthier and improve quality of life. 

Read the original research paper: Predictors of mortality and hospitalised exacerbations in obstructive airway diseases