Key result
Pulmonary hypertension in COPD linked to ~22% higher in-hospital mortality.
Why the study?
Chronic obstructive pulmonary disease may be complicated by pulmonary hypertension, but the impact of pulmonary hypertension on in-hospital mortality and 30-day readmissions was not well defined.
Does the presence of pulmonary hypertension increase in-hospital mortality and 30-day readmissions in adults with COPD?
Does the presence of pulmonary hypertension increase in-hospital mortality and 30-day readmissions in adults with COPD?
The presence of pulmonary hypertension in patients hospitalized with COPD is associated with a 22% increased odds of in-hospital mortality, identifying a high-risk subgroup that may benefit from targeted interventions.
PH in COPD was associated with higher in-hospital mortality; supports consensus but leaves causal inference and intervention trials open.
Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017–2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline COPD status were also obtained. There were 766,561 (7.43%) patients with concomitant PH and COPD among 10,312,543 patients with COPD. Patients with PH and COPD were older, female, and more often had a length of stay ≥7 days (all p < 0.001). Patients with PH suffered more from in-hospital mortality than those without PH (5.84% versus 3.94%, p < 0.001). PH predicted in-hospital mortality (adjusted odds ratio [aOR]: 1.22 [1.21–1.24], p < 0.001). COVID-19 (aOR: 6.20 [6.11–6.30]), metastatic cancer (aOR: 3.28 [3.23–3.32]), and moderate/severe liver disease (aOR: 3.09 [3.04–3.15]) were the strongest positive predictors of in-hospital mortality (all p < 0.001) in all patients with COPD. The 30-day readmission rate for the entire cohort was approximately 16%. Most patients had PH coded as unspecified/other.PH was associated with increased in-hospital mortality among patients with COPD, highlighting a high-risk group for targeted interventions to reduce morbidity and mortality.
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Khan et al. (2026) studied this question. Pulmonary hypertension in patients with COPD increased in-hospital mortality to 5.84% compared to 3.94% without PH (aOR 1.22, p < 0.001).
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