COPD Mortality Risk: Demographic Disparities in Hospitalized Patients

Thirty-day mortality outcomes for patients hospitalized for acute COPD exacerbations in the US appear to vary based on their demographics. Males are at elevated risk compared to females, and non-Hispanic Black patients and those in other or multi-racial groups are less likely to die than non-Hispanic White patients, a large retrospective study reports.

The researchers used data from the novel Epic Cosmos electronic health record database to analyze the 30-day risk of in-hospital death associated with race, ethnicity, and gender in the US. The 1,095,407 adults hospitalized for a COPD exacerbation from 2013 to 2023 had a principal discharge diagnosis of COPD and received systemic corticosteroids.

Study participants averaged around 70 years of age, and slightly more than half were female. Almost 80% were White, almost 12% were Black, around 3% were Hispanic, around 6% other or multi-racial, and almost 1% Asian. Around one-third of patients were current smokers, and around 45% were former smokers. Overall, 82,828 (around one-quarter) received Medicaid, and the median Elixhauser comorbidity index was 3.

Almost 70% of participants used antibiotics during their hospital stay. Around one quarter of the patients required non-invasive ventilation, while around 7% needed mechanical ventilation. Around 7% of patients experienced 30-day in-hospital death or were discharged to hospice care.

After the researchers adjusted for age, body mass index, Elixhauser comorbidities, Medicaid payment status, eosinophil count, COPD medication, vulnerability index determined by zip code, they found that non-Hispanic Black patients (aRR 0.85; 95% CI, 0.83-0.88) and other or multi-racial patients (absolute risk ratio [aRR] 0.76; 95% CI, 0.73-0.79) had lower mortality risk than non-Hispanic White patients. They also found that males had a 26% higher 30-day mortality risk than females (aRR 1.26; 95% CI, 1.24-1.28).

The demographics of patients with COPD are expected to evolve over the coming decades. To provide patients with optimal care, professionals need to understand how the disease affects various patient populations, the researchers note. They also advocate for further related research.

Reference Byers M, Staggers K, Ortiz J, et al. Association of Race, Ethnicity, and Gender on 30-Day Risk of Mortality Among Hospitalized Patients Admitted for COPD Exacerbations. Presented at: CHEST 2025, October 19-22, 2025; Chicago.