Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with ...

Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD)Prevalence and Impact of COPDSince the 1960s there has been an increase in morbidity in women with COPD. There has been an increasein mortality especially in men (Lacasse, Brooks & Goldstein, 1999). In 1999 in Canada, COPD was the fourthleading cause of death in men (5,544 deaths) and the fifth in women (3,974 deaths) (Canadian Institute for HealthInformation, Canadian Lung Association, Health Canada & Statistics Canada, 2001). From 1988 to 1999, although therates among men decreased by 7%, mortality rates in women increased by 53% and are still increasing.Mortality rates also increase rapidly for all individuals over 75 years of age. The change in age structure ofthe population with an increasing number of people aged over 65 years will result in continued increasesin mortality rates for COPD (particularly in women) in the foreseeable future. Furthermore, the estimatedmortality rate is a significant underestimation (Ernst, Bourbeau, Rainville, Benayoun & Suissa, 2000). In Canada in2000/2001, COPD was the seventh most common cause of hospitalization for men and the eighth mostcommon cause of hospitalization for women. Hospitalizations were greater for patients over 65 years ofage. Risk of rehospitalization is approximately 40% among patients with COPD (Canadian Institute for HealthInformation, Canadian Lung Association, Health Canada & Statistics Canada, 2001).The economic burden for COPD in Canada is enormous. In 1998, $467 million was spent on hospital careand drugs for COPD. Direct costs (premature mortality, long and short term disability) were estimated at$1.2 billion, with total cost therefore, estimated at $1.67 billion. It is suggested that this figure significantlyunderestimates the true costs because it does not include physician costs or costs related to communitybasedhealth services (Canadian Institute for Health Information, Canadian Lung Association, Health Canada & StatisticsCanada, 2001).Key Points■■■Mortality rates are increasing for all individuals over 75 years of age.In 1999 in Canada, COPD was the fourth leading cause of death in menand the fifth in women.Healthcare costs for COPD in Canada represent an enormouseconomic burden.20