955: Risk Factors for COPD Exacerbation During Hospitalization and Their Impact on Inpatient Mortality

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INTRODUCTION: Although the risk factors for COPD exacerbation have been identified, risk factors associated with COPD exacerbation during hospitalization and their impact on inpatient mortality remain to be studied. We conducted a retrospective data analysis to identify the most common admitting diagnoses among COPD patients who experienced an exacerbation during their hospitalization and studied their impact on inpatient mortality. METHODS: Data from Health Care Utilization Project's National Inpatient Sample (NIS) 2019 were analyzed. The ICD-10 codes were used to identify the admitting diagnosis for all discharges with a secondary diagnosis of COPD exacerbation. We omitted discharges for patients under the age of 40 to avoid misclassification. The Rao-Scott Chisquare test was used to compare categorical variables. The odds ratios were calculated using multivariable logistic regression. National estimates were based on sample weights. RESULTS: A total of 1,018,715 discharges had a secondary diagnosis of COPD exacerbation. The top admitting diagnoses were respiratory failure (20.4%), septicemia (17.9%), heart failure (HF) (14.4%), pneumonia (12.7%), bronchiectasis (4.8%), acute myocardial infarction (AMI) (2.2%), influenza (2.1%), cardiac dysrhythmias (1.9%), and aspiration pneumonitis (1.7%). All-cause mortality for all discharges with COPD exacerbation was 3.9%. Among discharges that experienced COPD exacerbation during hospitalization, higher mortality was noted for admitting diagnosis of septicemia (7.2%), AMI (5.6%), and aspiration pneumonitis (5.6%) (p< 0.0001 for all). In regression analysis, admitting diagnoses of septicemia (aOR:1.8;95% CI: 1.7-1.9; p< 0.0001) and AMI (aOR:1.3; 95% CI: 1.2- 1.5;p< 0.0001) were associated with higher odds of inpatient mortality. CONCLUSIONS: The most common admission diagnoses associated with COPD exacerbation during hospitalization were respiratory failure, septicemia, heart failure, and pneumonia. In addition, patients admitted for septicemia and AMI who experienced COPD exacerbation had a higher likelihood of inpatient mortality. COPD patients admitted for septicemia and AMI should be closely monitored for early identification of COPD exacerbations.

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Critical Care Medicine




1 (Supplement)

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52nd Society of Critical Care Medicine Critical Care Congress, SCCM 2023 held 2023-01-21 to 2023-01-24 in San Francisco, CA, USA.

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