Active smoking (p=0.022), higher COPD GOLD stage (p=0.023), and supplemental oxygen use (p<0.0001) were significantly associated with increased hospital admissions for COPD exacerbations.
Cohort (n=727)
What clinical and demographic factors predict hospitalization and mortality in adults with COPD exacerbations?
Active smoking, higher COPD GOLD stage, and supplemental oxygen use are significant predictors of hospitalization for COPD exacerbations, highlighting smoking cessation as a crucial modifiable risk factor.
Abstract Rationale Hospital admission and mortality among patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) are influenced by a complex interplay of clinical, demographic, social, and biological factors. Infectious etiologies, particularly bacterial and viral pathogens, are well-established triggers of COPD exacerbations. This study aimed to identify factors associated with hospitalization and mortality among patients with COPD in a central Pennsylvania cohort. Specifically, we examined pneumococcal and influenza vaccination profiles, demographic characteristics, body mass index, comorbid conditions (such as diabetes, chronic heart failure, hypertension, coronary artery disease), smoking history, supplemental oxygen use, and COPD GOLD stage. The primary outcome was the incidence of hospitalizations due to COPD exacerbations. Secondary outcome included all-cause mortality at 60 and 360 days. Methods The retrospective data from EMR (from 01/2022 to 02/2024) was used. 727 adults with COPD confirmed by pulmonary function tests who had COPD exacerbation within study period were included. 6 influenza and pneumococcal vaccination profiles were selected based on CDC criteria (before October 2024) compliance and the presence or absence of each vaccine. Chi-square test was used for categorical variables, while non-parametric Kruskal-Wallis test was applied to continuous variables. Negative binomial regression models were employed with the number of hospital admissions for COPD exacerbation as the outcome. Both univariate analysis and multivariate analysis were conducted. Results In the current study, the factors associated with an increased number of COPD exacerbations requiring hospital admission were active smoking (p = 0.022), a higher COPD GOLD stage (p = 0.023), and the use of supplemental oxygen (p 0.0001). No statistically significant predictors of mortality were identified, however, overall mortality in our cohort was low (1.4%, p 0.1). Conclusion Smoking cessation is a crucial modifiable risk factor for reducing the risk of COPD exacerbation. No specific vaccination profile demonstrated a statistically significant difference in preventing COPD exacerbations in our cohort. However, the protective effects of influenza and pneumococcal vaccinations in reducing COPD exacerbation risk have been well established in larger population-based studies. This abstract is funded by: None
Khapov et al. (Fri,) conducted a cohort in Chronic Obstructive Pulmonary Disease (COPD) exacerbations (n=727). Clinical and demographic predictors (smoking, GOLD stage, oxygen use, vaccination) was evaluated on Incidence of hospitalizations due to COPD exacerbations. Active smoking (p=0.022), higher COPD GOLD stage (p=0.023), and supplemental oxygen use (p<0.0001) were significantly associated with increased hospital admissions for COPD exacerbations.