(1176) Racial Disparities in Hospital Outcomes for Patients With Concurrent COPD Exacerbation and PE

Introduction: COPD increases the risk of developing Pulmonary Embolism (PE). Conversely, PE can cause COPD exacerbation. This study investigates racial disparities among hospitalized patients with concurrent COPD exacerbation and PE, adjusting for key economic factors.

Methods: A retrospective study was conducted using the National Inpatient Sample Database (2018 to 2020), utilizing ICD-10 codes. We searched for hospitalized adults with concomitant PE and COPD exacerbation. The primary outcome assessed was in-hospital mortality, while secondary outcomes were also queried using ICD-10 codes. Multivariate logistic regression was used to compare outcomes in different racial groups, adjusting for co-morbidities and specific demographic and economic factors.

Results: Among 130,895 patients with concurrent COPD exacerbation and PE, 78.5% were White, 10.1% Black, and 5.7% Hispanic. 12% of Whites, 11.5% of Blacks, and 9.2% of Hispanics had private insurance. Medicaid was more common among Blacks (22.4%) and Hispanics (14.7%) than whites (10.2%). Uninsured rates were 4.9% for whites, 5.6% for Blacks, and 5.8% for Hispanics. 38.2% of Whites were in the lowest income quartile compared to 60% of Blacks and 47.2% of Hispanics. Compared to Whites, Blacks and Hispanics had higher odds of AKI (1.68, 95% CI: 1.48-1.91, p < 0.000 and 1.33, 95% CI: 1.13-1.57, p=0.00053 respectively) and the need for noninvasive ventilation (1.69, 95% CI: 1.43-1.99, p< 0.0001 and 1.48, 95% CI: 1.19-1.84, p 0.00052 respectively). There was no statistically significant difference in in-hospital mortality, need for invasive ventilation, acute heart failure, and shock. But hospital stays were slightly longer and total hospital charges were higher in Black (0.23 day, 95%CI: 0.06-0.39, p 0.0076 and $6529.53, p< 0.0001) and Hispanic (0.32 day, 95% CI 0.11-0.54, p 0.0028 and $13272.5, p< 0.0001) patients.

Conclusions: Our study showed that for hospitalized patients with concurrent COPD exacerbation and PE, even after adjusting for key economic factors like income level and insurance coverage, Black and Hispanic patients had higher odds of AkI and required more non-invasive ventilation compared to White patients. Additionally, hospital charges and lengths of stay were higher for these groups, however, in-hospital mortality rates were similar.