P2967 - Impact of Cirrhosis on Patients Admitted With Acute COPD Exacerbation: A Nationwide Study

Adham Obeidat, MD¹, Ahmad Abou Yassine, MD², Mohammad Aldiabat, MD³, Ratib Mahfouz, MD⁴, George Holman, MD^2
1Presbyterian Hospital, Albuquerque, NM; ²University of New Mexico, Albuquerque, NM; ³Washington University in St. Louis, St. Louis, MO; ⁴Henry Ford Hospital, Detroit, MI

Introduction: Chronic obstructive pulmonary disease (COPD) has increasingly been identified as a major cause of death worldwide. The management of acute COPD exacerbation depends on severity. In cases of severe exacerbation, hospitalization is required. We study the potential impact of cirrhosis on the in-hospital mortality as well as other secondary outcomes in patients admitted with acute COPD exacerbation.

Methods: The United States Nationwide Inpatient Sample (NIS) database was used to extract hospitalization data of patients admitted between 2019 to 2021. Using ICD10 revision codes, we identified adults with the primary diagnosis of COPD exacerbation. We divided patients into two groups; cirrhosis vs no cirrhosis. The primary outcome was the in-hospital mortality. Secondary outcomes included sepsis, respiratory failure (RF), arrhythmias, pneumothorax, pulmonary embolism (PE), acute kidney injury (AKI) and length of stay (LOS). Multivariate logistic regression was used to adjust for relevant variables.

Results: An estimated 914,498 patients were admitted with COPD exacerbation. 38,310 patients had the diagnosis of cirrhosis. In cirrhotic patients, the mean age was 62.2 years. 31.5% were females and 79.5% were Caucasians. 10.5% of cirrhotic patients died during hospitalization compared to 5.8% of non-cirrhotics. Alcohol use, smoking and malnutrition were more prevalent among cirrhotics. Cirrhotic patients had a longer LOS (8.4 vs 6.3), and more financial burden with total hospital charges of 101,061$ vs 74,363$.



When adjusted to other relevant variables, cirrhosis was associated with increased in-hospital mortality (OR 1.26; P-value < 0.001). Further, cirrhosis was associated with an increased chance of developing sepsis, AKI, encephalopathy and prolonged LOS. Moreover, cirrhosis increased the chance of developing an arrhythmia and cardiac arrest, however, this association was not significant. Interestingly cirrhotic patients had a lower chance for PE, pneumothorax and RF (see Table 1).

Discussion: COPD exacerbation is a common cause of hospitalization in the US. In this study, we concluded that cirrhosis is associated with increased in-hospital mortality among patients with acute COPD exacerbation. Moreover, it can increase the chance of developing other in-hospital complications that will lead to an increased LOS and total hospital charges. We advise clinicians to be attentive when treating cirrhotic patients with acute COPD exacerbation, and to closely monitor for in-hospital complications.


Disclosures:


Adham Obeidat, MD¹, Ahmad Abou Yassine, MD², Mohammad Aldiabat, MD³, Ratib Mahfouz, MD⁴, George Holman, MD². P2967 - Impact of Cirrhosis on Patients Admitted With Acute COPD Exacerbation: A Nationwide Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.