SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The course of chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States, is characterized by exacerbations. Recurrent exacerbations are currently the third leading cause of 30-day readmissions among Medicare patients with substantial cost burden. Computed tomography (CT) imaging has been used in defining phenotypes in COPD with poor clinical outcomes. However, CT findings in patients readmitted within 30 days of an acute exacerbation have not been well characterized. The purpose of this study was to determine whether any specific CT findings in this population could influence management of acute exacerbations of COPD. METHODS: This was a single center, retrospective study conducted in a university hospital with local IRB approval. CT scan findings in patients with COPD readmitted within 30-days of a hospitalization between December 2017 and November 2019 were evaluated. We included patients who had a chest CT performed on their readmission as part of routine care. Descriptive statistics were used to analyze the data. RESULTS: We included 84 patients (mean age 66±9.8 years). Of these, 47 (55%) were males and 41 (49%) were current smokers. The average length of time out of the hospital was 15.2±8.3 days. There were 71 patients with a principal admitting diagnosis of COPD exacerbation or pneumonia. The predominant CT findings were airspace consolidation (46%), emphysema (46%), mucus plugging/retained airway secretions (30%), mediastinal/hilar adenopathy (30%), pulmonary nodules (28%) and bronchial wall thickening (26%). An increased pulmonary artery diameter, suggesting pulmonary hypertension, was noted in 18 (25%) patients. CT pulmonary angiograms were performed in thirty-seven (52%) studies with pulmonary emboli detected in only 3 patients. CONCLUSIONS: CT findings in 30-day COPD readmissions are widely varied. However, airspace consolidations, emphysema, retained airway secretions and enlargement of the pulmonary arteries were common findings. Contrary to popular belief, prevalence of pulmonary embolism was low in our patients. CLINICAL IMPLICATIONS: Focusing on airway clearance therapies could be beneficial in the management of patients with acute exacerbations of COPD. DISCLOSURES: No relevant relationships by Isaac Biney, source=Web Response Advisory Committee Member relationship with Boehringer-Ingelheim Please note: $5001 - $20000 Added 07/18/2020 by Rajiv Dhand, source=Web Response, value=Consulting fee Advisory Committee Member relationship with GSK Please note: $1001 - $5000 Added 07/18/2020 by Rajiv Dhand, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Mylan Please note: $1001 - $5000 Added 07/18/2020 by Rajiv Dhand, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Teva Please note: $1001 - $5000 Added 07/18/2020 by Rajiv Dhand, source=Web Response, value=Consulting Advisory Committee Member relationship with Astra Zeneca Please note: $5001 - $20000 Added 07/18/2020 by Rajiv Dhand, source=Web Response, value=Consulting fee No relevant relationships by Tina Dudney, source=Web Response No relevant relationships by Jennifer Ferris, source=Web Response no disclosure on file for Jeffrey Peeke; no disclosure on file for James Shamiyeh