In-hospital mortality patterns and readmissions in patients with chronic obstructive pulmonary disease: An analysis of the role of pulmonary hypertension

Authors

Saad Afzal Khan, Aga Khan University
Trishna Parikh, University of Houston College of Medicine, USA
Adishwar Rao, University of Houston College of Medicine, USA
Farah Kazzaz, University of Houston College of Medicine, USA
Sarah Shin, University of Houston College of Medicine, USA
Harry Karmouty Quintana, University of Houston College of Medicine, USA
Maulin Patel, University of Houston College of Medicine, USA
Kha Dinh, University of Houston College of Medicine, USA
Bela Patel, University of Houston College of Medicine, USA
Bindu Akkanti, University of Houston College of Medicine, USA

Document Type

Article

Department

Medical College Pakistan

Abstract

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline COPD status were also obtained. There were 766,561 (7.43%) patients with concomitant PH and COPD among 10,312,543 patients with COPD. Patients with PH and COPD were older, female, and more often had a length of stay ≥7 days (all p < 0.001). Patients with PH suffered more from in-hospital mortality than those without PH (5.84% versus 3.94%, p < 0.001). PH predicted in-hospital mortality (adjusted odds ratio [aOR]: 1.22 [1.21-1.24], p < 0.001). COVID-19 (aOR: 6.20 [6.11-6.30]), metastatic cancer (aOR: 3.28 [3.23-3.32]), and moderate/severe liver disease (aOR: 3.09 [3.04-3.15]) were the strongest positive predictors of in-hospital mortality (all p < 0.001) in all patients with COPD. The 30-day readmission rate for the entire cohort was approximately 16%. Most patients had PH coded as unspecified/other.PH was associated with increased in-hospital mortality among patients with COPD, highlighting a high-risk group for targeted interventions to reduce morbidity and mortality.

Comments

Pagination is not provided by author/publisher.

AKU Student

no

Publication (Name of Journal)

Journal of Chronic Obstructive Pulmonary Disease

DOI

10.1080/15412555.2025.2582902

Recommended Citation

Khan, S. A., Parikh, T., Rao, A., Kazzaz, F., Shin, S., Quintana, H. K., Patel, M., Dinh, K., Patel, B., Akkanti, B. (2026). In-hospital mortality patterns and readmissions in patients with chronic obstructive pulmonary disease: An analysis of the role of pulmonary hypertension. Journal of Chronic Obstructive Pulmonary Disease, 23(1).
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/586