SESSION TITLE: New Insights into COPD and Its Complications SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: This study aimed to Quantify the Impact of Pulmonary Hypertension (PH) mortality, 30-day readmission, Morbidity, and Resource utilization among patients with Acute exacerbation of chronic obstructive pulmonary disorder (AECOPD). METHODS: This is a retrospective analysis by using the 2016 and 2017 National Readmission Database (NRD). Inclusion criteria were admissions with a diagnosis of AECOPD, as a primary diagnosis and pulmonary Hypertension (PH) as a secondary diagnosis using ICD 10-CM codes. Exclusion criteria were age under 18 years, non-elective admission, and discharge in December. The primary outcome was in-hospital Mortality during the index admission. Secondary outcomes were 30-Day Readmission rates, Resource utilization, and Morbidity Including Intubation rates (IR), Prolong Invasive Mechanical Ventilation >96hr (PIMV), Tracheostomy Rate (TR), Chest tube Placement rate (CR) and Bronchoscopy rate (BR) during the Index admission. We used multivariate linear/logistic models to adjust for confounders. RESULTS: 821,468 patients with AECOPD were included in the study, and 68,429 (8.33 %) patients had a diagnosis of PH. PH was more common among females (61.1%) with a mean age of 70, Medicare recipients (79.5%), with higher Charlson Comorbidity burden, lower economic status, and treated in a large urban teaching hospital. PH is associated with greater in-hospital mortality (adjusted odds ratio (aOR): 1.89, Confidence Interval (CI):1.73- 2.07 , P<0.01), higher 30 day readmission aOR-1.24,(CI)-1.21-1.28,p<0.001 compared to patient without PHT. In addition, PHT was associated with higher morbidity including IR (aOR: 199, CI: 1.85 -2.14,p<0.01), PIMV (aOR: 2.12, CI:1.89-2.38, p<0.001), TR (aOR-2.15,CI-1.53-2.9,p<0.001), BR(aOR-1.46,CI-1.11-1.94,p<0.007) and CR(aOR-1.39,CI-1.11-1.74,p<0.004). PH was also associated with higher resource utilization with total hospitalization cost (aMD: $2785, CI: 2602-2967, p<0.01) and LOS (aMD-1.09,CI-1.02-1.15,p<0.001). Independent predictors of higher 30-day readmissions were age group of 30-50 years, Index LOS> 3days, Medicare Insurance recipients, Higher Charlson Comorbidity burden, higher Hospital volume quintile for AECOPD, Opioid and cocaine-dependent, discharge other than routine during the index hospitalization. In contrast, independent predictors of lower 30-day readmissions were female gender, private insurance recipients, and Uninsured, higher Household income, and people who reside in the small metropolitan area during the index admission. CONCLUSIONS: PH is related to higher in-hospital Mortality, morbidity, IR, BR, TR, PIMV, CR, and Resource utilization, including total Hospitalization Cost and LOS. We also found predictors for readmission. CLINICAL IMPLICATIONS: Early diagnosis and appropriate treatment of PH, Close Follow up and Early referral to lung transplant will be beneficial to such patients who found to have PH in Management of AECOPD. DISCLOSURES: No relevant relationships by Rucha Jiyani, source=Web Response No relevant relationships by Si Li, source=Web Response No relevant relationships by Palakkumar Patel, source=Web Response No relevant relationships by Pranavi Patel, source=Web Response No relevant relationships by Yichen Wang, source=Web Response