To Örebro University

Rationale: Cardiopulmonary risk refers to the elevated likelihood of serious cardiovascular or respiratory events among patients with COPD, compared with the general population, beyond what would be attributable to shared risk factors (eg, smoking, older age). This study evaluated healthcare resource utilization and associated costs in patients with COPD who have experienced cardiopulmonary events.

Methods: This retrospective study utilized data from 100% Medicare Fee-for-Service and Inovalon MORE2 Registry® of closed claims from 1/1/2020-3/31/2024. Patients 40+ years old with ≥2 COPD diagnosi scodes in 2021 were categorized based on the presence or absence of a cardiopulmonary event (hospitalization for COPD, acute heart failure, cardiac arrest, myocardial infarction or revascularisation procedure) any time after COPD diagnosis. For those with an event, index date was the earliest event date. Patients without an event were matched according to age, sex, payer type, region of residence, and the Elixhauser Comorbidity Index, and assigned a proxy index date based on the time between the COPD diagnosis and the cardiopulmonary event of their matched counterpart. All patients were required to present 12 months of continuous health plan enrolment preceding and following the index date. All-cause, COPD-related, and cardiovascular disease (CVD)-related healthcare resource utilization, associated costs, and other select clinical outcomes/therapies of interest were assessed during the 12-month follow-up period. Differences were assessed using paired t-tests.

Results: After matching, 138,584 pairs of patients with COPD with and without a cardiopulmonary event (representing 13.5% of the full ABACOS OUTCOMES cohort) were included in the analysis (Table). Patients experiencing a cardiopulmonary event were significantly more likely to have subsequent all-cause, COPD-related, and CVD-related hospital admissions, and all-cause, COPD-related, and CVD-related emergency department visits compared with patients without a cardiopulmonary event during the follow-up period. Similar trends were observed for outpatient utilization. All-cause hospital costs were 433% greater and total direct healthcare costs were 126% greater among patients with a cardiopulmonary event compared with patients without an event. Patients with cardiopulmonary events also experienced significantly more moderate COPD exacerbations, utilization of oxygen therapy, mechanical ventilation, and ICU stays.

Conclusions: Patients with COPD experiencing a cardiopulmonary event exhibit significantly increased CVD- and COPD-related healthcare resource utilization and costs during 1 year of follow-up, as well as higher need for critical care, compared with patients without such an event in a real-world setting. Results highlight the importance of proactive management of COPD to help reduce cardiopulmonary risk and economic burden.