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Abstract

SESSION TITLE: Impact of Health Disparities and Differences SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Living in rural areas is associated with higher COPD prevalence, even among never-smokers. In addition, the rural residence increased a 70% increase in the odds of total COPD exacerbations. Patients living in rural areas have a 46% higher incidence rate of COPD exacerbations. In this study, we explored the impact of a residential area on the COPD outcomes such as exacerbation, change in pulmonary function, and quality of life in a highly urbanized country. METHODS: This study was a prospective, non-interventional, observational cohort study. Patients were recruited from 54 medical centers in South Korea between December 2011 and January 2018. Using data of 2,119 patients from the KOCOSS (Korea COPD Subgroup Study) cohort, we compared the demographic and residential characteristics, development of exacerbation, change of pulmonary function, and quality of life according to the residential area. RESULTS: A total of 1,083 (51.1%) patients were living in the large city, 548 (25.9%) in small & medium-sized cities, and 488 (23.0%) in the rural area at the enrollment. According to the residential area, there was a significant difference in dyspnea severity and quality of life at baseline. The mean mMRC score was 1.42 for patients living in the rural area, 1.35 for those from small and medium-sized cities, and 1.24 for large cities, respectively (p<0.001). The mean SGRQc for the rural area was 33.7 and 31.8 for small and medium-sized cities and 30.6 for large cities (p=0.028). The CAT score was not different at baseline. The moderate exacerbations developed more frequently in rural areas than urban areas during follow-up (3.56 for rural areas, 3.44 for small & medium-sized cities, and 2.39 for large cities, p=0.001). A similar trend was observed for severe exacerbations but statistically not significant (0.74 for rural areas, 0.72 for small & medium-sized cities, and 0.49 for large cities, p=0.054). FEV1 and FVC were highest for patients from large cities in the first and second years of follow-up. There were no significant differences in total CAT scores and SGRQc during follow-up. CONCLUSIONS: This study showed the clinical COPD outcomes between residential area groups. Patients living in rural areas experienced moderate exacerbation more frequently. Other outcomes, such as severe exacerbation, quality of life, or lung function, had similar development patterns but did not meet the statistical significance. CLINICAL IMPLICATIONS: The residential area does not seem to impact the clinical outcome of COPD patients except for moderate exacerbation. The good accessibility to health care facilities in South Korea can partly explain our findings. DISCLOSURES: No relevant relationships by Yong Il Hwang No relevant relationships by Chang Youl Lee No relevant relationships by Kyu Jin Lee no disclosure submitted for Yong Bum Park; No relevant relationships by KWANG HA YOO