Abstract 14875: Chronic Obstructive Pulmonary Disease Negatively Affects In-hospital Outcomes in Patients With Takotsubo Cardiomyopathy

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a known comorbidity of takotsubo cardiomyopathy (TCM), and COPD exacerbation is a potential trigger of TCM. The association between COPD and in-hospital outcomes and complications in TCM patients is not well established. Aim: We aimed to assess the effect of COPD on hospitalized patients with a primary diagnosis of TCM. Methods: Using the latest National Inpatient Sample from 2016-2017, we conducted a retrospective cohort study in patients with a primary diagnosis of TCM with or without COPD. The diagnosis was identified by the ICD-10-CM coding system. We identified 3,139 patients admitted with a primary diagnosis of TCM; 684 of those patients also had a diagnosis of COPD. We performed propensity score matching in a 1:2 ratio (n=678 patients, matched COPD group; n=1,070, matched non-COPD group) and compared in-hospital outcomes and complications between TCM patients with and without a COPD diagnosis. Results: Before matching, the COPD group had worse outcomes compared with the non-COPD group in inpatient death (2.9% vs. 1.3%, p=0.006), length of stay (LOS) (4.02±2.99 days vs. 3.27±3.39 days, p<0.001), hospitalization costs ($55,242.68±47,637.40 vs. $48,316.97±47,939.84, p=0.001), and acute respiratory failure (ARF) (22.5% vs. 7.7%, p<0.001), respectively. After propensity score matching, the matched COPD group, compared with the matched non-COPD group, had a higher inpatient mortality rate (2.9% vs.1.0%, p=0.005), longer LOS (4.02±3.00 days vs. 3.40±3.54 days, p<0.001), higher hospitalization costs ($55,409.23±47,809.13 vs. $44,6469.60±42,209.10, p<0.001), and a higher incidence of ARF (22.6% vs. 8.2%, p<0.001) and cardiogenic shock (5.6% vs. 3.3%, p=0.024), respectively. Conclusions: Patients who are hospitalized for TCM and have COPD have higher rates of inpatient mortality, ARF, and cardiogenic shock, as well as a longer LOS and a higher cost of stay than TCM patients without COPD. Prospective studies are warranted to examine the effect of early intervention or treatment of COPD on short and long-term outcomes of TCM.