ArticleBMJ open respiratory research2026
Nationwide trends in AECOPD care in Italy before, during and after COVID-19: discrepancies between data sources and across regions.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Impact of diabetes mellitus on mortality in patients with acute exacerbation of chronic obstructive Pulmonary disease: a meta-analysis and systematic review.Frontiers in endocrinology · 2026Pooled it
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8 authors.
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Abstract
backgroundAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a leading cause of hospital admissions, early mortality and readmissions. Italian data are outdated and fragmented, and the impact of COVID-19 on AECOPD outcomes remains unclear.
methodsWe conducted a nationwide descriptive analysis of aggregated administrative indicators derived from two institutional sources (SDO (Schede di Dimissione Ospedaliera) and AGENAS (Agenzia Nazionale per i Servizi Sanitari Regionali)), reporting national and regional trends in hospitalisations, 30-day postdischarge mortality and 30-day readmissions for AECOPD between 2015 and 2023. Data were compared across pre-COVID (2015-2019), COVID (2020-2021) and post-COVID (2022-2023) periods and stratified by region and health district. Analyses were descriptive and based on aggregated, standardised administrative indicators, with temporal and regional comparisons across pre-COVID, COVID and post-COVID periods.
resultsAECOPD hospitalisations declined by more than 45% during 2020-2021, with only partial recovery by 2023 (-24% vs 2019). Thirty-day postdischarge mortality rose sharply during the pandemic, peaking at 13.6% in 2021 (+47% vs 2019), before returning near baseline in 2023, though excess mortality persisted in several southern regions. Thirty-day readmission rates remained stable at 12%-14% across the study period. Importantly, SDO records captured only one quarter of cases identified by AGENAS, systematically underestimating the true hospitalisation burden.
conclusionsCOVID-19 profoundly disrupted AECOPD care in Italy, exposing entrenched regional inequities and critical limitations in administrative data. These findings call for modernisation of coding systems, strengthening of community-based respiratory care and implementation of structured discharge and follow-up pathways to ensure equity and resilience in COPD management.
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