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10.3390/jcm14176045
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Nationwide Trends and Outcomes of Alcohol Use Disorders in COPD Hospitalizations in Spain, 2016–2023

by
Teresa Gómez-Garcia
1,
Rodrigo Jiménez-Garcia
2,
Valentín Hernández-Barrera
3,
Ana López-de-Andrés
4,
David Carabantes-Alarcon
2,*,
Ana Jiménez-Sierra
5,
Elena Labajo-González
6,
Andrés Bodas-Pinedo
2 and
Javier de-Miguel-Diez
1
1
Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
2
Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
3
Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Madrid, Spain
4
Department of Public Health and Maternal & Child Health, Faculty of Pharmacy, Universidad Com-plutense de Madrid, IdISSC, 28040 Madrid, Spain
5
Faculty of Medicine, Universidad San Pablo Ceu, 28668 Madrid, Spain
6
Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(17), 6045; https://doi.org/10.3390/jcm14176045
Submission received: 8 July 2025 / Revised: 1 August 2025 / Accepted: 25 August 2025 / Published: 26 August 2025
(This article belongs to the Section Respiratory Medicine)
Versions Notes

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent condition with high morbidity and mortality, often accompanied by comorbidities such as alcohol use disorder (AUD). A thorough understanding of the interaction between COPD and AUD is crucial for improving patient outcomes and addressing management challenges. Objectives: This study analyzed temporal trends, clinical characteristics, and hospital outcomes associated with AUD among adults hospitalized with COPD in Spain between 2016 and 2023. Methods: A population-based cohort study was conducted using the Spanish Hospital Discharge Registry. We included adults aged ≥40 years with a diagnosis of COPD. AUD was identified through ICD-10 codes. Temporal trends in AUD prevalence were evaluated using Joinpoint regression, stratified by sex. We also assessed clinical characteristics including pneumonia, obesity, asthma, obstructive sleep apnea (OSA), supplemental oxygen use, long-term steroid use, and mechanical ventilation. Outcomes analyzed included ICU admission and in-hospital mortality (IHM). Results: Among 2,545,151 COPD hospitalizations, 263,568 (10.35%) had an AUD diagnosis. AUD prevalence rose from 8.66% in 2016 to 12.57% in 2023, with a sharper increase in women. Patients with AUD were younger and had higher rates of tobacco use (84.11% vs. 49.33%; p < 0.001) and psychiatric disorders. Multivariable analysis showed male sex, substance use, psychiatric illness, and external cause admissions were independently associated with AUD. Although overall IHM was lower in AUD patients (7.46% vs. 8.2%; p < 0.001), it increased with age, pneumonia, COVID-19, and higher comorbidity. IHM rose progressively, peaking in 2023 (15.6%). Conclusions: AUD prevalence in COPD hospitalizations increased significantly, especially in women. IHM also rose over time. These results highlight the need for integrated approaches targeting mental health and substance use in COPD management.
Keywords: chronic obstructive pulmonary disease; COPD; alcohol use disorder; psychiatric comorbidities prevalence; substance use hospitalization; mortality; sex chronic obstructive pulmonary disease; COPD; alcohol use disorder; psychiatric comorbidities prevalence; substance use hospitalization; mortality; sex

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MDPI and ACS Style

Gómez-Garcia, T.; Jiménez-Garcia, R.; Hernández-Barrera, V.; López-de-Andrés, A.; Carabantes-Alarcon, D.; Jiménez-Sierra, A.; Labajo-González, E.; Bodas-Pinedo, A.; de-Miguel-Diez, J. Nationwide Trends and Outcomes of Alcohol Use Disorders in COPD Hospitalizations in Spain, 2016–2023. J. Clin. Med. 2025, 14, 6045. https://doi.org/10.3390/jcm14176045

AMA Style

Gómez-Garcia T, Jiménez-Garcia R, Hernández-Barrera V, López-de-Andrés A, Carabantes-Alarcon D, Jiménez-Sierra A, Labajo-González E, Bodas-Pinedo A, de-Miguel-Diez J. Nationwide Trends and Outcomes of Alcohol Use Disorders in COPD Hospitalizations in Spain, 2016–2023. Journal of Clinical Medicine. 2025; 14(17):6045. https://doi.org/10.3390/jcm14176045

Chicago/Turabian Style

Gómez-Garcia, Teresa, Rodrigo Jiménez-Garcia, Valentín Hernández-Barrera, Ana López-de-Andrés, David Carabantes-Alarcon, Ana Jiménez-Sierra, Elena Labajo-González, Andrés Bodas-Pinedo, and Javier de-Miguel-Diez. 2025. "Nationwide Trends and Outcomes of Alcohol Use Disorders in COPD Hospitalizations in Spain, 2016–2023" Journal of Clinical Medicine 14, no. 17: 6045. https://doi.org/10.3390/jcm14176045

APA Style

Gómez-Garcia, T., Jiménez-Garcia, R., Hernández-Barrera, V., López-de-Andrés, A., Carabantes-Alarcon, D., Jiménez-Sierra, A., Labajo-González, E., Bodas-Pinedo, A., & de-Miguel-Diez, J. (2025). Nationwide Trends and Outcomes of Alcohol Use Disorders in COPD Hospitalizations in Spain, 2016–2023. Journal of Clinical Medicine, 14(17), 6045. https://doi.org/10.3390/jcm14176045

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