Racial disparities in the mortality and health-care resource utilization of heart failure patients with chronic obstructive pulmonary disease

Increased mortality rates in chronic obstructive pulmonary disease (COPD) patients with heart failure (HF) are believed to be driven by various factors, including disparities in access to healthcare services and shifting dynamics of the population characteristics. In this study, we examined the racial and ethnic disparities in the clinical outcomes of HF in COPD patients in the United States, analyzing data from the Nationwide Inpatient Sample database. The database was searched retrospectively from 2016 to 2022 to identify COPD and HF patients by International Classification of Diseases-10 codes. A total of 2445545 individuals were included of which 76% were Whites, 16% were Blacks, 5% Hispanics and 3% others. Whites were significantly older than other populations (P < 0.001), and a significantly higher proportion of Blacks were females compared to other racial groups. Regarding clinical outcomes, Black COPD patients with HF had the lowest mortality rates while it was similar between Whites and Hispanics (P < 0.001). Compared to Whites, the adjusted odds ratio was significantly lower for Blacks, 0.797 95% confidence interval (CI): 0.783-0.812; P < 0.001 and Hispanics, 0.956 (95%CI: 0.932-0.981; P = 0.001). Other racial groups had significantly higher mortality compared to Whites, with an adjusted odds ratio of 1.131 (95%CI: 1.099-1.164; P < 0.001). Individuals from other racial groups had significantly longer hospital stay, and hospitalization cost adjusted for inflation. Cardiac arrest was the strongest predictor (P < 0.001) for in-hospital mortality in all racial groups.