Incidence, risk factors, and outcomes of respiratory related hospitalizations in older patients with COPD, asthma, and bronchiectasis

Abstract

The increasing prevalence of chronic respiratory diseases among older adults significantly affects morbidity and mortality rates. Hospitalizations from exacerbations and acute respiratory infections (ARIs) pose a substantial burden on healthcare systems. This study aimed to estimate the nationwide incidence of such hospitalizations among older adults with chronic respiratory diseases, identify risk factors, and assess outcomes like intensive care needs and mortality. Utilizing data from the National Health Insurance Service senior cohort (2016–2017), we analyzed patients aged 60 and above diagnosed with chronic obstructive pulmonary disease, asthma, or bronchiectasis. We followed hospitalization rates over two years, employing Cox regression models to identify predictors for hospitalizations. Out of 117,793 patients, 16,024 (13.6%) patients had overlapping respiratory diseases with COPD, asthma and/or bronchiectasis. Of the total population, 9.6% were hospitalized due to exacerbations or ARIs, showing an incidence rate of 10.6 per 100 patient-years. Notably, patients with multiple respiratory diseases had hospitalization rates over 20%. Of the 24,186 hospitalizations, 6.5% necessitated intensive care, and 2.2% were fatal. Increased risk of hospitalization was associated with being 85 or older, having multiple respiratory conditions, and taking certain medications such as antipsychotics and anti-dementia drugs. This study reveals a notable rate of hospitalization due to exacerbations or ARIs among older adults with chronic respiratory diseases, with age, multiple conditions, and specific medications being major risk factors. The findings underscore the need for targeted preventive strategies and careful management of this vulnerable population. © The Author(s) 2025.