Impact of offspring and their educational level on readmission and death among older adults with chronic obstructive pulmonary disease: a nationwide cohort study using multistate survival models.
| Title: | Impact of offspring and their educational level on readmission and death among older adults with chronic obstructive pulmonary disease: a nationwide cohort study using multistate survival models. |
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| Authors: | Sloth MMB; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark mathildemarie@me.com.; Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark.; Neble Larsen E; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark.; Godtfredsen NS; Department of Respiratory Diseases, Hvidovre Hospital, Hvidovre, Denmark.; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Osler M; Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark.; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Jørgensen TSH; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark. |
| Source: | Journal of epidemiology and community health [J Epidemiol Community Health] 2023 Sep; Vol. 77 (9), pp. 558-564. Date of Electronic Publication: 2023 Jun 13. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: British Medical Assn Country of Publication: England NLM ID: 7909766 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1470-2738 (Electronic) Linking ISSN: 0143005X NLM ISO Abbreviation: J Epidemiol Community Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London, British Medical Assn. |
| MeSH Terms: | Pulmonary Disease, Chronic Obstructive*/diagnosis ; Pulmonary Disease, Chronic Obstructive*/epidemiology ; Patient Readmission*; Aged ; Female ; Humans ; Male ; Cohort Studies ; Disease Progression ; Educational Status ; Retrospective Studies ; Risk Factors |
| Abstract: | Background: It is well described that there is social inequality in the disease course of chronic obstructive pulmonary disease (COPD), but the impact of social relations is less explored. We aimed to investigate the impact of adult offspring and their educational level on readmission and death among older adults with COPD.; Methods: In total, 71 084 older adults born 1935-53 with COPD diagnosed at age ≥65 years in 2000-2018 were included. Multistate survival models were performed to estimate the impact of adult offspring (offspring (reference) vs no offspring) and their educational level (low, medium or high (reference)) on the transition intensities between three states: COPD diagnosis, readmission and all-cause death.; Results: During follow-up, 29 828 (42.0%) had a readmission and 18 504 (26.0%) died with or without readmission. Not having offspring was associated with higher hazards of death without readmission (HRwomen: 1.52 (95% CI: 1.39 to 1.67), HRmen: 1.29 (95% CI: 1.20 to 1.39)) and a higher hazard of death after readmission for women only (HRwomen: 1.19 (95% CI: 1.08 to 1.30). Having offspring with low educational level was associated with higher hazards of readmission (HRwomen: 1.12 (95% CI: 1.06 to 1.19)), (HRmen: 1.06 (95%CI: 1.002 to 1.12)), death without readmission (HRwomen: 1.24 (95% CI: 1.11 to 1.39)), HRmen: 1.16 (95% CI: 1.05 to 1.29) and death after readmission for men only (HRmen: 1.15 (95% CI: 1.05 to 1.25)). Having offspring with medium educational level was associated with a higher hazard of death without readmission for women (HRwomen: 1.11 (95% CI: 1.02 to 1.21)).; Conclusion: Adult offspring and their educational level were associated with higher risk of readmission and death among older adults with COPD.; (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Competing Interests: | Competing interests: None declared. |
| Contributed Indexing: | Keywords: COHORT STUDIES; EPIDEMIOLOGY; GERONTOLOGY; HEALTHCARE DISPARITIES; SOCIAL CAPITAL |
| Entry Date(s): | Date Created: 20230613 Date Completed: 20230825 Latest Revision: 20230825 |
| Update Code: | 20260130 |
| DOI: | 10.1136/jech-2022-220243 |
| PMID: | 37311624 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't