Patients with COPD who undergo major surgery are more likely to die in the year after surgery than similar patients without COPD, according to a new study published in the Canadian Medical Association Journal.

Research also revealed that these patients incur higher healthcare costs than non-COPD patients, post-surgery.

The study included 932,616 patients aged 35 years and older in Ontario who underwent major surgery, including total hip or knee replacement, gastrointestinal surgery, vascular surgery and other elective noncardiac surgeries.

Of all patients, about 1-in-5 (170,482) had COPD. Patients with COPD were older, and more likely to be male, frail, have lower income and have pre-existing conditions such as coronary artery disease, diabetes and lung cancers.

Researchers found that compared with demographically similar patients without COPD undergoing similar surgery, people with COPD had a 61% increased risk of dying and a 13% increase in healthcare costs in the year after surgery.

According to the data, these increased risks and costs were evident long after the immediate 30-day postoperative period.

“Because patients with COPD are often frail and have many health problems, their management around the time of surgery should address not only COPD but all their health issues,” said Dr. Ashwin Sankar, an anesthesiologist at St Michael’s Hospital and the University of Toronto.

“Patients with COPD typically have concurrent comorbidity, biopsychosocial issues and frailty,” the author wrote. “Our findings highlight the importance of careful risk prediction and decision-making for patients with COPD who are considering surgery.”

They hope that their findings of increased healthcare costs will help with system-level planning by policy-makers and hospital administrators to better respond to the postsurgical needs of people with COPD.

“Understanding the longer-term outcomes of surgical patients with COPD is critically important to accurately guide informed consent discussions and project care needs,” the researchers wrote. “Delineating [healthcare costs for these patients] would facilitate system-level budgeting and resource allocation.”