Patients with chronic obstructive pulmonary disease (COPD) are not receiving optimum care and more than 1 in 10 who are admitted to hospital die within 90 days, health experts said on Wednesday.

COPD is the fifth most common cause of death in England and Wales. But doctors say the illness is not given enough priority in the state-funded National Health Service.

“Care received by COPD patients remains a lottery with many not benefiting from the potentially life-saving and life-enhancing care provided by a specialist respiratory team,” said Dr. Mike Roberts, of the Royal College of Physicians (RCP).

In the first national audit of the illness by the RCP and the British Thoracic Society, Roberts and his colleagues found that COPD accounts for more than 10 percent of all acute hospital admissions but more than half of patients are not under the care of a specialist.

Deaths rates, length of stay and readmissions to hospital vary greatly.

Smoking is the leading cause of COPD. A smoker is 10 times more likely to die of the illness than a non-smoker. It begins with a persistent cough and increased mucous. Eventually COPD leads to fatigue, shortness of breath and difficulty breathing as the lungs begin to fail.

Deaths from the illness have been rising in most countries. It is frequently seen in people over 40 years old who have been smoking for many years and contributes to other illnesses such as pneumonia, heart disease and stroke.

“This audit highlights the huge problem of COPD in the UK,” said Helena Shovelton, chief executive of the British Lung Foundation.

“There are more than 900,000 people diagnosed with COPD in the UK - and a suspected further 1.5 million undiagnosed - and it is time that the government made COPD a priority,” she added.

The experts said the findings reveal the need for more respiratory physicians and specialist nurses to improve the care of COPD patients.