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Objective: Hospital admissions in COPD patients, represent a health care overload and an economic burden as well as they worsen the patient prognosis. Our objective was to describe the prevalence of these events in a ‘real life’ cohort of two years of follow-up. Methods: Retrospective population-based cohort study. 1792 COPD patients were selected by simple random sampling from all COPD patients in Cantabria (Northern Spain). Severe exacerbations (hospitalization due to COPD exacerbation) were computed during each year of follow up, as well as admissions for another cause. Results: There were 343 severe exacerbations, belonging to 228 patients. In other words, only 12.7% of patients had at least one admission per COPD exacerbation in the first follow-up year. Most of these patients had only one (162/228, 71.1%) or two admissions (43/228, 18.9%), although the remaining 23 patients (10.1%) accumulated a total of 95 admissions (27.7%) with a range of 3 to 8 admissions per patient. The next year 362 admissions were recorded and 34 patients (15.5% of severe exacerbations) accumulated 35.9% (130/362) of admissions, ranging from 3 to 7 admissions per patient. Regarding admissions for another cause, there were 240 belonging to 176 patients, so 9.8% of patients had at least one admission for other reasons during the first year. The next year, this % increased to 13.8%. The range of admissions for other causes was from 1 to 7 and again less than 10% of patients accumulated more than 20% of these admissions. Conclusions: Our data suggest that less than 15% of patients have hospital admissions. However, there is a patient profile that tends to accumulate re-admissions, requiring political-health interventions in this sense.

Objective: Several studies support that the risk of asthma exacerbations (AE) is higher in women than in men. We analyze whether this association can be explained by confounding due to variables such as obesity or older age. Methods: Retrospective population-based cohort study including 2000 asthmatic adult patients obtained by simple-random-sampling. AE requiring oral corticosteroid were considered as ‘moderate’, and AE requiring ‘parenteral corticosteroid and/or magnesium sulphate’ were considered as ‘severe’. Adjusted Odds Ratios (OR) and their 95% confidence intervals (95%CI) were estimated by logistic regression. Results: The overall mean age was 41.7 years [SD=19.7], with 46.2 % of men and 53.8 % of women. Women had a higher risk of suffering at least one moderate exacerbation the follow-up year: OR 2.01; 95%CI (1.42 to 2.85). Both obesity: OR 2.40; 95%CI (1.51 to 3.81) and age: OR (increase per decade) 1.31; 95%CI (.1.21 to 1.41) were associated with a higher risk of AE, meeting the criteria to be treated as confounding variables. After including age as a confounding variable, the association between being female and the risk of AE did not change substantially: OR 1.56; 95%CI (1.09 to 2.25). After including obesity (BMI) association also remained: OR 1.73; 95%CI (1.16 to 2.57). However, after including both obesity and age together in the same multivariable model, the association between being female and the risk of AE diminished and lost statistical significance: OR 1.44; 95% CI (0.95 to 2.17). Conclusions: Female gender is associated with an increased risk of AE. However, this association can be explained by women’s older age and obesity, acting both as confounders.

Objective: To determine the comorbidities associated to a poor control of asthma. Methods: Retrospective population-based cohort study including 2000 asthmatic patients obtained by simple-random-sampling. Asthma exacerbations were defined as episodes requiring at least oral corticosteroid. The excessive use of rescue medication was determined by the ‘asthma medication ratio’, being the ratio Results: 7.9% of patients suffered from at least one moderate exacerbation during the monitoring year. The 15.1% of the patients scored Conclusions: Psychiatric history, cardiovascular disease and chronic renal failure were independently associated to a worse control of asthma. The association for chronic renal failure was especially strong and deserve further consideration.