Abstract Background Low testosterone levels have been associated with increased all-cause mortality. Male patients with Chronic Obstructive Pulmonary Diseases (COPD) have higher prevalence of low testosterone levels with up to 69% compared to 20% in healthy men 60 years. Our goal was to investigate the association of Hormone replacement therapy (HRT) with testosterone on mortality and clinical outcomes of patients admitted with COPD exacerbation. Method: We queried the National Inpatient Sample (NIS) Database from 2019-2022 and conducted a retrospective analysis of patients admitted with COPD using ICD 10 codes. Patients were divided into two groups: using HRT or not. Using both univariate and multivariate analyses, we compared various in-hospital outcomes and adjusted for confounders. Results We identified 535650 admissions for COPD/Male, out of which 8330 (1. 5%) had a concomitant use of HRT. The mean age in the COPD-HRT group was 68 years, whereas that of NHRT group was 49 years. The primary outcome of interest was in-hospital mortality. Secondary outcomes included length of stay (LOS), total hospitalization charges (TOTCHG), Cardiac Arrest (CA), Stroke, Acute Kidney Injury (AKI), Acute Heart Failure (AHF), Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE). There was an overall decreased mortality difference in COPD HRT group adjusted odd Ratio (aOR): 0. 48, CI 0. 27-0. 85, p 0. 012. Regarding secondary outcomes, there were significantly less AHF aOR: 0. 48, CL 0. 26-0. 90, p 0. 022 and mean LOS (4 days vs 4 days, Coefficient -0. 6 (-0. 85 - 0. 48, p 0. 00) in the COPD HRT cohort compared to COPD NHRT group. There were no differences in TOTCHG (40121 vs 40083, p 0. 01), rates of CA aOR: 0. 75 CI 0. 34-1. 68, p 0. 49, stroke aOR: 1. 31, CI: 0. 40-4. 23, p 0. 65, AKI aOR: 1. 04, CI 0. 91-1. 19, p 0. 55, DVT aOR: 0. 99, CI 0. 57-1. 92, p 0. 98, PE aOR: 1. 12, CI 0. 90-1. 37, p 0. 308 between groups. Conclusion COPD patients are known to have higher prevalence of testosterone deficiency compared to the general population, which could be contributing to higher mortality risk. Our data indicated mortality benefits of using HRT in COPD patients. This highlights the importance of monitoring testosterone levels in COPD patients. Testosterone replacement was not only associated with mortality benefits but also decreased AHF without increasing risk of stroke, DVT and PE. These findings raise the question of whether testosterone surveillance in COPD patients should be part of the COPD evaluation. This abstract is funded by: None
Sumrain et al. (Fri,) studied this question.