B44-20 Multimorbidity Patterns Reveal Heterogeneity Among Hospitalized Patients With Chronic Obstructive Pulmonary Disease: Analysis From a Multicenter Cross-sectional Survey in China

Abstract Rationale Chronic obstructive pulmonary disease (COPD) is a major global health burden, characterized by significant heterogeneity. While comorbidity is the rule rather than the exception in COPD, existing phenotyping often underemphasizes multimorbidity clusters. The patterns and clinical impacts of these multimorbidity clusters remain inadequately characterized in large Chinese populations, limiting personalized care strategies. This study aimed to identify clinically distinct multimorbidity patterns among a large cohort of hospitalized COPD patients in China and to rigorously evaluate their independent associations with healthcare resource utilization and critical short-term clinical outcomes. Methods We conducted a multicenter, retrospective cross-sectional study analyzing electronic medical records of 17,828 COPD inpatients from six tertiary hospitals across China (2019-2024). Using latent class analysis (LCA) on 25 prevalent comorbidities (3%), we derived multimorbidity patterns. Multivariable logistic and linear regression models, adjusted for age, gender, and other demographic and clinical covariates, were used to assess the associations between class membership and outcomes including length of stay, total costs, in-hospital mortality, and respiratory. Results The study cohort had a high multimorbidity burden (87.6% with ≥1 comorbidity). LCA robustly identified five distinct patterns: “Low Comorbidity” (53.7%), “Asthma-Rhinitis” (8.5%), “Metabolic Disease” (18.1%), “Cardiovascular Disease” (13.5%), and “Pulmonary Hypertension” (6.1%). Strikingly, the “Pulmonary Hypertension” class demonstrated the most severe profile: longest median stay (10.3 days), highest median costs (¥17,204), and markedly elevated adjusted risks for mortality (OR 2.04, 95% CI 1.39-2.91) and respiratory failure (OR 3.75, 95% CI 3.30-4.28) compared to the “Low Comorbidity” class. The “Cardiovascular Disease” class also showed significantly increased healthcare utilization and adverse outcome risks. Sensitivity analyses confirmed the robustness of these associations. Conclusions This large, multicenter study reveals five clinically distinct and prognostically significant multimorbidity patterns in Chinese COPD inpatients. The “Pulmonary Hypertension” and “Cardiovascular Disease” patterns are strong, independent predictors of a heightened healthcare burden and poor in-hospital outcomes. These findings provide a foundation for comorbidity-driven risk stratification, enabling more personalized management and efficient resource allocation in this complex patient population. This abstract is funded by: Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0506003)