Where Do Chronic Obstructive Pulmonary Disease Patients Die? 8-Year Trend, with Special Focus on Sex-Related Differences

Background: To plan end-of-life care it is essential to ascertain where patients die. There is very little information on the place of death of chronic obstructive pulmonary disease (COPD) patients. Accordingly, this study set out to describe the place of death of all COPD-related deaths in a Spanish region across the period 2009-2017, taking into account the sex and age of the deceased. Methods: We analyzed COPD deaths, codes J41-44 of the International Classification of Diseases-10th revision, in the Galician Autonomous Region from 2009 to 2017. Using death certificate data furnished by the Galician Mortality Registry, information was extracted on place of death, categorized as "hospital", "nursing home", "patient's home", "other" or "not shown". Results: There were 10,274 deaths, with a male:female ratio of 2.52; 39.0% of deaths occurred in hospital and 41.4% at home, with these data varying according to sex and age. Across the study period, no reduction was observed in the number of deaths that occurred in hospital. For all the period analyzed, deaths among women occurred mostly at home, with an increase being seen in the number of deaths in nursing homes over the course of the study. Patients aged under 70 years tended to die more frequently in hospital, and those over this age died more frequently at home or in nursing homes. Conclusion: A very high percentage of COPD patients still die in hospital, a trend that has shown no decline in recent years. Even so, there are important variations by sex and age on the place of death of these patients.