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Patients may require hospital inpatient care for severe acute exacerbations of COPD. Episodes that are life threatening sometimes require temporary assistance with breathing.

Acute exacerbations of COPD are frequently due to bacterial or viral respiratory tract infections. They have also been associated with increases in exposure to air pollution and changes in ambient temperature.

In 2009–10 there were 54,244 hospital separations of people 55 years and over where COPD was the principal diagnosis.

The hospital separation rate for males 55 years and over declined 20% in the last decade from 1,545 per 100,000 population in 1998–99 to 1,236 in 2009–10.

The female rate, while varying a little over the same period, was slightly higher in 2009–10 (870 per 100,000 population) than it was in 1998–99 (835 per 100,000 population).

The decreasing rate of COPD hospital separations among males is contrary to a general trend of increasing hospital separation rates for all conditions for both sexes.

COPD - hospitalisations 1998-99 to 2009-10 GIF

Notes
1. Age standardised to the Australian population as at 30 June 2001.
2. COPD classified according to International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) codes J40 to J44.
3. Separations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
4. COPD occurs mostly in people aged 55 years and over. While it is occasionally reported in younger age groups, in those aged 55 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only people aged 55 years and over are included in this graph.

Source: AIHW National Hospital Morbidity Database.

There is a strong seasonal driver of COPD exacerbations. Admissions to hospital for COPD are highest in winter and early spring. This matches and is related to the trend for acute respiratory infections (e.g. rhinovirus (common cold), influenza, pneumonia and acute bronchitis).

COPD - hospitalisations by season

Notes
1. COPD classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes J40 to J44, National Centre for Classification of Health.
2. Acute respiratory infections classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes J00–J22 (e.g. rhinovirus (common cold), influenza, pneumonia and acute bronchitis).
3. Admissions for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
4. COPD occurs mostly in people aged 55 years and over. While it is occasionally reported in younger age groups, in those aged 55 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only people aged 55 years and over are included in this graph.

Source: AIHW National Hospital Morbidity Database.

Source tables

Table 1: Hospital separations per 100,000 population for Australians with COPD aged 55+ years, 1998–99 to 2009–10
Males Females
1998–99 1,544.8 835.0
1999-00 1,557.6 852.8
2000–01 1,566.5 889.7
2001–02 1,528.8 884.7
2002–03 1,547.1 911.5
2003–04 1,509.8 916.1
2004–05 1,439.1 867.3
2005–06 1,381.2 871.2
2006–07 1,302.8 833.2
2007–08 1,355.1 883.8
2008–09 1,316.7 919.3
2009–10 1,236.1 869.8

Notes
1. Age standardised to the Australian population as at 30 June 2001.
2. COPD classified according to International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) codes J40 to J44.
3. Separations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
4. COPD occurs mostly in people aged 55 years and over. While it is occasionally reported in younger age groups, in those aged 55 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only people aged 55 years and over are included in this graph.

Source: AIHW National Hospital Morbidity Database.

Table 2: Hospital admissions per 100,000 population for Australians with an acute respiratory infection (ARI) or COPD, aged 55+ years, 2005 to 2009 by month
Month 2005 2006 2007 2008 2009
ARI COPD ARI COPD ARI COPD ARI COPD ARI COPD
Jan 7,254 3,585 7,643 3,540 7,069 3,587 7,980 3,876 8,248 4,134
Feb 6,602 2,961 7,456 3,004 6,528 2,869 7,723 3,281 7,847 3,256
Mar 7,949 3,557 8,803 3,541 8,410 3,510 9,730 3,964 9,451 3,790
Apr 8,318 3,612 9,303 3,660 8,837 3,865 10,182 4,240 10,075 4,169
May 10,204 4,209 10,080 4,272 10,394 4,324 11,783 5,040 11,835 4,840
Jun 12,951 5,238 12,961 5,125 12,759 5,273 14,129 5,497 15,449 5,773
Jul 16,595 6,801 15,801 6,046 18,560 7,818 15,956 6,761 19,846 7,272
Aug 16,063 6,602 16,356 6,639 20,492 8,090 18,254 8,018 16,479 6,216
Sep 13,198 5,814 13,415 5,957 15,041 6,351 16,633 7,770 13,854 5,822
Oct 10,806 5,028 10,327 4,912 11,861 5,697 12,568 6,013 12,896 6,152
Nov 9,510 4,085 8,894 4,115 9,643 4,497 10,543 5,012 10,496 4,730
Dec 9,408 4,275 8,319 3,944 9,130 4,367 10,133 5,003 10,003 4,799

Notes
1. COPD classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes J40 to J44, National Centre for Classification of Health.
2. Acute respiratory infections classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes J00–J22 (e.g. rhinovirus (common cold), influenza, pneumonia and acute bronchitis).
3. Separations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
4. COPD occurs mostly in people aged 55 years and over. While it is occasionally reported in younger age groups, in those aged 55 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only people aged 55 years and over are included in this graph.

Source: AIHW National Hospital Morbidity Database.